In 2023， multiple international societies proposed the concept of metabolic-dysfunction and alcohol-associated liver disease （MetALD） to characterize patients with steatotic liver disease who exhibit metabolic dysfunction and consume alcohol at a moderate level. In recent years， the evidence system in this field has been constantly developed and improved. This article reviews the latest research advances in MetALD from the aspects of background， definition， epidemiological characteristics， natural history， clinical phenotype， diagnostic and assessment methods， and treatment regimens， as well as the directions for future investigation.

Objective To investigate the effect and mechanism of action of epigallocatechin-3-gallate(EGCG)in the treatment of experimental metabolic dysfunction-associated steatohepatitis(MASH),and to provide a basis for clinical development and application.Methods A total of 32 experimental C57BL/6J mice were randomly divided into normal diet group(Con group with 8 mice)and model group with 24 mice.The mice in the model group were given a high-trans fatty acid high-carbohydrate(HFHC)diet for 24 weeks to establish a model of MASH,and at the end of week 24,the mice in the model group were further divided into HFHC group,EGCG treatment group(100 mg·kg-1·d-1),and obeticholic acid treatment group(10 mg·kg-1·d-1),with 8 mice in each group.After 6 weeks of treatment,samples were collected to observe the general conditions of mice;the content of triglycerides(TG)and hydroxyproline in liver tissue and the serum levels of alanine aminotransferase(ALT)and aspartate aminotransferase(AST)were measured;HE staining,oil red O staining,and picrosirius red staining were used to observe liver histopathological changes.In the in vitro experiment,L02 cells were induced with free fatty acid(FFA)to establish a model of lipid deposition,and the cells were divided into Con group,FFA group,and EGCG group.The content of TG in cells was measured,as well as the results of oil red O staining and the relative mRNA expression levels of TNF-α,CCL2,and CXCL10.The transcriptomics technique was used to identify differentially expressed genes between the Con group,the HFHC group,and the EGCG group and perform the GSEA analysis,and pathways with a P-adjust value of<0.05 that were associated with MASH were further classified into metabolism-related pathways and inflammation-related pathways.The specific signaling pathways in each category were ranked based on the degree of enrichment,and key genes in the top three pathways were verified by PCR in vivo.Key genes in the NOD-like receptor signaling pathway were verified by Western blotting.A one-way analysis of variance was used for comparison of normally distributed continuous data with homogeneity of variance between multiple groups,and the least significant difference t-test was used for further comparison between two groups.Results Compared with the HFHC group,the EGCG group had significant reductions in the content of TG in liver tissue(P<0.05)and the serum levels of ALT and AST(P<0.05).Oil red O staining showed significant alleviation of hepatocyte fatty degeneration in the EGCG group,HE staining showed that EGCG effectively alleviated inflammation,and picrosirius red staining showed a significant reduction in the number of fibrous tissue after EGCG treatment.There was a significant reduction in the content of hydroxyproline in liver tissue after EGCG intervention(P<0.01).Cell experiments showed that compared with the FFA group,the EGCG group had a significant reduction in the content of TG,and oil red O staining showed the disappearance of lipid droplets in the EGCG group compared with the FFA group,with significant reductions in the relative mRNA expression levels of the inflammatory factors TNF-α,CCL2,and CXCL10(all P<0.01).The transcriptomics analysis identified 230 differentially expressed genes between the HFHC group and the EGCG group,among which there were 108 upregulated genes and 122 downregulated genes.EGCG significantly reduced the levels of the key proteins TLR4,NLRP3,and IL-1β in the NOD-like receptor signaling pathway in liver tissue(all P<0.05).Conclusion EGCG can significantly alleviate lipid deposition,inflammation,and fibrosis in the mouse model of MASH and improve lipid deposition and inflammatory injury in L02 cells,possibly by regulating the NOD-like receptor signaling pathway.

Objective To investigate the current symptom status of maintenance hemodialysis(MHD)patients,analyze the influencing factors from the perspective of multidimensional symptom burden,extract symptom groups,and construct a symptom network.Methods A total of 490 patients who received MHD at the blood purification center of a tertiary hospital in Shanghai from March to April 2025 were selected using a convenience sampling method.30 symptoms of MHD patients were investigated using a modified dialysis symptom index table.SPSS and R software were utilized to analyze the influencing factors,extract symptom groups,and construct a multidimensional symptom network.Results A total of 488 valid questionnaires were collected,with a valid questionnaire recovery rate of 99.59％.The median number of symptoms experienced by patients was 6(interquartile range:4,8),with the top 5 symptoms being dry skin(69.88％),fatigue or tiredness(56.97％),itching(56.97％),worry(50.20％),and dry mouth(46.31％).Multidimensional analysis indicated that age,duration of dialysis,education level,and complications were influencing factors of symptom burden scores across different dimensions.6 stable symptom groups were extracted,namely skin discomfort,fatigue and pain,gastrointestinal tract,sleep disorders,water-electrolyte imbalance,and uremia.The results of the symptom network analysis revealed that difficulty of falling asleep had the highest intensity centrality(rs=2.18,2.25,2.12).Conclusion The symptom association is relatively stable,and difficulty of falling asleep is the core symptom.This finding can assist clinical medical staff in achieving efficiency and precision in symptom group management.

Vast majority of human RNA are non-coding RNA(ncRNA),which can regulate physiological activities and affects functions on cells.Although each part of them is obscure,they are involved in different levels of gene regulation,from epigene-tic gene silencing to post transcriptional regulation.Metabolic reprogramming of tumor-associated macrophages(TAMs)can promote tumor progression and is closely related to activation phenotypes of anti-tumor(M1)or pro-tumor(M2).A lot of ncRNAs are involved in metabolic reprogramming of TAMs,reshaping tumor microenvironment and playing a key role in tumor progression.Improving understanding of effect on ncRNA regulating metabolic reprogramming of TAMs may provide new methods for developing effective clinical treatments.

Objective To investigate the effect and mechanism of action of epigallocatechin-3-gallate(EGCG)in the treatment of experimental metabolic dysfunction-associated steatohepatitis(MASH),and to provide a basis for clinical development and application.Methods A total of 32 experimental C57BL/6J mice were randomly divided into normal diet group(Con group with 8 mice)and model group with 24 mice.The mice in the model group were given a high-trans fatty acid high-carbohydrate(HFHC)diet for 24 weeks to establish a model of MASH,and at the end of week 24,the mice in the model group were further divided into HFHC group,EGCG treatment group(100 mg·kg-1·d-1),and obeticholic acid treatment group(10 mg·kg-1·d-1),with 8 mice in each group.After 6 weeks of treatment,samples were collected to observe the general conditions of mice;the content of triglycerides(TG)and hydroxyproline in liver tissue and the serum levels of alanine aminotransferase(ALT)and aspartate aminotransferase(AST)were measured;HE staining,oil red O staining,and picrosirius red staining were used to observe liver histopathological changes.In the in vitro experiment,L02 cells were induced with free fatty acid(FFA)to establish a model of lipid deposition,and the cells were divided into Con group,FFA group,and EGCG group.The content of TG in cells was measured,as well as the results of oil red O staining and the relative mRNA expression levels of TNF-α,CCL2,and CXCL10.The transcriptomics technique was used to identify differentially expressed genes between the Con group,the HFHC group,and the EGCG group and perform the GSEA analysis,and pathways with a P-adjust value of<0.05 that were associated with MASH were further classified into metabolism-related pathways and inflammation-related pathways.The specific signaling pathways in each category were ranked based on the degree of enrichment,and key genes in the top three pathways were verified by PCR in vivo.Key genes in the NOD-like receptor signaling pathway were verified by Western blotting.A one-way analysis of variance was used for comparison of normally distributed continuous data with homogeneity of variance between multiple groups,and the least significant difference t-test was used for further comparison between two groups.Results Compared with the HFHC group,the EGCG group had significant reductions in the content of TG in liver tissue(P<0.05)and the serum levels of ALT and AST(P<0.05).Oil red O staining showed significant alleviation of hepatocyte fatty degeneration in the EGCG group,HE staining showed that EGCG effectively alleviated inflammation,and picrosirius red staining showed a significant reduction in the number of fibrous tissue after EGCG treatment.There was a significant reduction in the content of hydroxyproline in liver tissue after EGCG intervention(P<0.01).Cell experiments showed that compared with the FFA group,the EGCG group had a significant reduction in the content of TG,and oil red O staining showed the disappearance of lipid droplets in the EGCG group compared with the FFA group,with significant reductions in the relative mRNA expression levels of the inflammatory factors TNF-α,CCL2,and CXCL10(all P<0.01).The transcriptomics analysis identified 230 differentially expressed genes between the HFHC group and the EGCG group,among which there were 108 upregulated genes and 122 downregulated genes.EGCG significantly reduced the levels of the key proteins TLR4,NLRP3,and IL-1β in the NOD-like receptor signaling pathway in liver tissue(all P<0.05).Conclusion EGCG can significantly alleviate lipid deposition,inflammation,and fibrosis in the mouse model of MASH and improve lipid deposition and inflammatory injury in L02 cells,possibly by regulating the NOD-like receptor signaling pathway.

Objective To investigate the current symptom status of maintenance hemodialysis(MHD)patients,analyze the influencing factors from the perspective of multidimensional symptom burden,extract symptom groups,and construct a symptom network.Methods A total of 490 patients who received MHD at the blood purification center of a tertiary hospital in Shanghai from March to April 2025 were selected using a convenience sampling method.30 symptoms of MHD patients were investigated using a modified dialysis symptom index table.SPSS and R software were utilized to analyze the influencing factors,extract symptom groups,and construct a multidimensional symptom network.Results A total of 488 valid questionnaires were collected,with a valid questionnaire recovery rate of 99.59％.The median number of symptoms experienced by patients was 6(interquartile range:4,8),with the top 5 symptoms being dry skin(69.88％),fatigue or tiredness(56.97％),itching(56.97％),worry(50.20％),and dry mouth(46.31％).Multidimensional analysis indicated that age,duration of dialysis,education level,and complications were influencing factors of symptom burden scores across different dimensions.6 stable symptom groups were extracted,namely skin discomfort,fatigue and pain,gastrointestinal tract,sleep disorders,water-electrolyte imbalance,and uremia.The results of the symptom network analysis revealed that difficulty of falling asleep had the highest intensity centrality(rs=2.18,2.25,2.12).Conclusion The symptom association is relatively stable,and difficulty of falling asleep is the core symptom.This finding can assist clinical medical staff in achieving efficiency and precision in symptom group management.

Objective:To apply patent metrics to analyze the distribution, development trends, and characteristics of patents related to orthokeratology lenses for assisted wearing, providing a reference for the research and development of such patents.Methods:Patents related to orthokeratology lenses for assisted wearing were retrieved by computer from the China National Intellectual Property Administration database, incopat, Derwent Innovations Index, Free Patents Online, Organisation Africaine de la Propriété Intellectuelle, and IP Australia. The search timeframe was from the establishing of these databases until March 8, 2024. Patent metrics methods, word frequency analysis, and high-frequency word co-occurrence analysis were used for data analysis.Results:A total of 60 relevant patents were selected. The development of orthokeratology lens-assisted wearing patents began relatively late but has shown a strong growth trend, reaching a peak around 2015. Chinese patents accounted for the largest share (91.7%, 55/60) , with Zhejiang Province, Beijing City, Jiangsu Province, Guangdong Province, and Shanghai City having the highest number of patents. The majority of the applicants were enterprises. The research focus in this field is on mechanical assistance patents for lens wearing, with cutting-edge technologies focusing on monitoring the displacement of lenses relative to the pupil and providing timely feedback and guidance.Conclusions:This study, using patent metrics, word frequency analysis, and high-frequency word co-occurrence analysis, provides a reference for patent applications and product development in orthokeratology lens-assisted wearing in nursing.

Objective:To apply patent metrics to analyze the distribution, development trends, and characteristics of patents related to orthokeratology lenses for assisted wearing, providing a reference for the research and development of such patents.Methods:Patents related to orthokeratology lenses for assisted wearing were retrieved by computer from the China National Intellectual Property Administration database, incopat, Derwent Innovations Index, Free Patents Online, Organisation Africaine de la Propriété Intellectuelle, and IP Australia. The search timeframe was from the establishing of these databases until March 8, 2024. Patent metrics methods, word frequency analysis, and high-frequency word co-occurrence analysis were used for data analysis.Results:A total of 60 relevant patents were selected. The development of orthokeratology lens-assisted wearing patents began relatively late but has shown a strong growth trend, reaching a peak around 2015. Chinese patents accounted for the largest share (91.7%, 55/60) , with Zhejiang Province, Beijing City, Jiangsu Province, Guangdong Province, and Shanghai City having the highest number of patents. The majority of the applicants were enterprises. The research focus in this field is on mechanical assistance patents for lens wearing, with cutting-edge technologies focusing on monitoring the displacement of lenses relative to the pupil and providing timely feedback and guidance.Conclusions:This study, using patent metrics, word frequency analysis, and high-frequency word co-occurrence analysis, provides a reference for patent applications and product development in orthokeratology lens-assisted wearing in nursing.

Vast majority of human RNA are non-coding RNA(ncRNA),which can regulate physiological activities and affects functions on cells.Although each part of them is obscure,they are involved in different levels of gene regulation,from epigene-tic gene silencing to post transcriptional regulation.Metabolic reprogramming of tumor-associated macrophages(TAMs)can promote tumor progression and is closely related to activation phenotypes of anti-tumor(M1)or pro-tumor(M2).A lot of ncRNAs are involved in metabolic reprogramming of TAMs,reshaping tumor microenvironment and playing a key role in tumor progression.Improving understanding of effect on ncRNA regulating metabolic reprogramming of TAMs may provide new methods for developing effective clinical treatments.

Objective To establish the rapid identification method of Hedysari Radix wild and cultivated products by integrating the identification characteristics of TCM traits obtained by intelligent senses such as electronic nose and colorimeter based on the multivariate statistical analysis method;To provide new ideas and methods for the formulation of commodity specification standards and the application research of market quality control for Hedysari Radix.Methods Totally 29 batches of samples of Hedysari Radix were detected based on colorimeter and electronic nose technology to obtain their sensory information,and the effective components of Hedysari Radix were determined by high performance liquid chromatography(HPLC)and other methods for joint analysis.After establishing the optimal experimental conditions of Hedysari Radix electronic nose,multivariate statistical analysis methods,such as principal component analysis(PCA),orthogonal partial least squares-discriminant analysis(OPLS-DA)and clustering analysis,were used to establish the identification model of Hedysari Radix wild and cultivated commodities.Results The optimum test conditions of Hedysari Radix electronic nose(particle size of 65 mesh):the sample weight was 2.0 g,the optimum temperature of the sample was 50℃,and the time was 25 min.A single intelligent sensory result could not quickly and accurately identify the two,but the fusion information could quickly identify the wild and cultivated commodities of Hedysari Radix,and the chemical composition had a certain correlation with the color and taste.Conclusion Electronic nose and colorimeter can quickly and accurately distinguish wild and cultivated Hedysari Radix after multivariate statistical analysis,which is simple and feasible.The combined analysis of its related properties and active components can be used for the quality evaluation of Hedysari Radix.