Idiopathic pulmonary fibrosis (IPF), a chronic interstitial lung disease, is characterized by aberrant wound healing, excessive scarring and the formation of myofibroblastic foci. Although the role of alternative splicing (AS) in the pathogenesis of organ fibrosis has garnered increasing attention, its specific contribution to pulmonary fibrosis remains incompletely understood. In this study, we identified an up-regulation of serine/arginine-rich splicing factor 7 (SRSF7) in lung fibroblasts derived from IPF patients and a bleomycin (BLM)-induced mouse model, and further characterized its functional role in both human fetal lung fibroblasts and mice. We demonstrated that enhanced expression of Srsf7 in mice spontaneously induced alveolar collagen accumulation. Mechanistically, we investigated alternative splicing events and revealed that SRSF7 modulates the alternative splicing of pyruvate kinase (PKM), leading to metabolic dysregulation and fibroblast activation. In vivo studies showed that fibroblast-specific knockout of Srsf7 in conditional knockout mice conferred resistance to bleomycin-induced pulmonary fibrosis. Importantly, through drug screening, we identified lomitapide as a novel modulator of SRSF7, which effectively mitigated experimental pulmonary fibrosis. Collectively, our findings elucidate a molecular pathway by which SRSF7 drives fibroblast metabolic dysregulation and propose a potential therapeutic strategy for pulmonary fibrosis.

Inflammatory bowel disease (IBD) is an autoimmune disorder involving complex immune regulation, where balancing localized and systemic immunosuppression is a key challenge. This study aimed to enhance the therapeutic efficacy by engineering the probiotic Escherichia coli Nissle 1917 (EcN). We removed endogenous plasmids pMUT1 and pMUT2 from wild-type EcN and expressed the mPD-L1 (19‒238 aa)-mFc fusion protein on the bacterial surface using a cytolysin A (ClyA) fragment. This modification stabilized mPD-L1 (19‒238 aa) protein expression and promoted its recruitment to outer membrane vesicles (OMVs). The engineered strain, EcNΔ_pMUT1/2-ClyA-mPD-L1-mFc (EcN-ePD-L1-mFc), features conditional ePD-L1-mFc expression under the araBAD promoter, enhancing gut-targeted release and reducing systemic side effects. This strain improved treatment targeting and efficiency by enabling direct ePD-L1-mFc interaction with immune cells at inflammation sites. OMVs from this strain induced Treg proliferation, inhibited effector T cell proliferation in vitro, and significantly improved intestinal inflammation and colonic epithelial barrier repair in vivo. Additionally, the bacterium restored intestinal microbiota balance, increasing Lactobacillaceae and reducing Bacteroides. This study highlights the engineered bacterium's potential for targeted intestinal immune modulation and offers a novel local IBD treatment approach with promising clinical prospects.

Traditional Chinese medicine (TCM) is an ancient medical system distinctive and effective in treating cancer, depression, coronavirus disease 2019 (COVID-19), and other diseases. However, the relatively abstract diagnostic methods of TCM lack objective measurement, and the complex mechanisms of action are difficult to comprehend, which hinders the application and internationalization of TCM. Recently, while breakthroughs have been made in utilizing methods such as network pharmacology and virtual screening for TCM research, the rise of machine learning (ML) has significantly enhanced their integration with TCM. This article introduces representative methodological cases in quality control, mechanism research, diagnosis, and treatment processes of TCM, revealing the potential applications of ML technology in TCM. Furthermore, the challenges faced by ML in TCM applications are summarized, and future directions are discussed.

This study investigated the regulatory potential of salidroside (SAL), a primary active compound in Rhodiola rosea L., on osteoclast differentiation by modulating the hypoxia-inducible factor 1-alpha (HIF-1a) pathway in osteoblasts. Luciferase reporter assay and chromatin immunoprecipitation (ChIP) assay were employed to validate whether the receptor activator of nuclear factor-?B ligand (RANKL) is the downstream target gene of HIF-1a in osteoblasts. The study also utilized lipopolysaccharide (LPS)-induced mouse osteolysis to examine the impact of SAL on osteolysis in vivo. Furthermore, conditioned medium (CM) from SAL-pretreated osteoblasts was used to investigate the paracrine effects on osteoclastogenesis through the HIF-1a pathway. Hypoxic condition-induced overexpression of HIF-1a upregulated RANKL levels by binding to the RANKL promoter and enhancing transcription in osteoblastic cells. In vivo, SAL significantly alleviated bone tissue hypoxia and decreased the expression of HIF-1a by downregulating the expression of RANKL, vascular endothelial growth factor (VEGF), interleukin 6 (IL-6), and angiopoietin-like 4 (ANGPTL4). In the paracrine experiment, conditioned media from SAL-pretreated osteoblasts inhibited differentiation through the HIF-1a/RANKL, VEGF, IL-6, and ANGPTL4 pathways. RANKL emerges as the downstream target gene regulated by HIF-1a in osteoblasts. SAL significantly alleviates bone tissue hypoxia and bone loss in LPS-induced osteolysis through the HIF-1a/RANKL, VEGF, IL-6, and ANGPTL4 pathways. SAL inhibits osteoclast differentiation by regulating osteoblast paracrine secretion.
Animals ; Osteoblasts/cytology* ; Hypoxia-Inducible Factor 1, alpha Subunit/genetics* ; Glucosides/administration & dosage* ; Cell Differentiation/drug effects* ; Phenols/administration & dosage* ; Mice ; Osteoclasts/metabolism* ; RANK Ligand/genetics* ; Rhodiola/chemistry* ; Osteogenesis/drug effects* ; Signal Transduction/drug effects* ; Interleukin-6/genetics* ; Male ; RAW 264.7 Cells ; Osteolysis/genetics* ; Humans ; Mice, Inbred C57BL

Objective:To establish new scar-endoscopic submucosal dissection (scar-ESD) classification based on the relationship between scars and lesion location under endoscopy, and to explore the clinical efficacy of ESD.Methods:Clinical data of 132 patients who underwent ESD with scars from January 2015 to August 2022 at the Digestive Endoscopy Center of Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine. According to the scar-ESD classification, the lesions without surgical anastomosis at the same location were classified as type A: A0, A1, A2, and A3; and those with surgical anastomosis were classified as type B: B0, B1, and B2. The ESD operation time, specimen size, intraoperative assistant methods, intraoperative perforation, en-bloc resection rate, specimen damage rate, and postoperative complications were recorded for each subtype.Results:The age of the 132 patients was 64.22±9.51, with a male-to-female ratio of 3∶1. Forty-nine lesions (37.12%) were located in the esophagus, 40 cases (30.30%) in the stomach, and 43 cases (32.58%) in the colon. The operation time was 49.66±32.96 minutes. The operation time for A0 subtype was 30.38±12.85 minutes, which was significantly shorter than that of the A2 (52.10±36.55 minutes, t=2.15, P<0.05). The operation time for B0 subtype was 45.03±24.35 minutes, which was significantly shorter than that of the B2 (90.71±44.95 minutes, t=3.95, P<0.05). Intraoperative assistance was used in 38 cases (28.79%). Intraoperative perforation occurred in 5 cases (3.79%), including 4 cases of A2 and 1 case of A3, and the highest incidence occurred in the colon [9.30% (4/43)]. The en-bloc resection rate was 97.73% (129/132), the R0 resection rate was 88.64% (117/132), and the curative resection rate was 84.09% (111/132). The specimen damage occurred in 23 cases (17.42%), with the highest incidence in the stomach [32.50% (13/40)]. There were significant differences between A2 and A0 subtypes ( t=2.31, P<0.05) in this variable, and between B2 subtype and A0, A1, A2, A3, and B0 subtypes ( P<0.05). Conclusion:The scar-ESD classification is beneficial for describing and predicting difficulty of ESD. ESD is still the preferred treatment for early digestive lesions with scars, and the efficacy is satisfactory. But it requires experienced physicians to perform the operation.

Objective:To explore the development trends, frontiers, and hotspots of research on early rehabilitation for patients with severe neurological diseases at home and abroad in the past 10 years, with a view to providing reference for the development of early rehabilitation for patients with severe neurological diseases in China.Methods:The article on early rehabilitation for patients with severe neurological diseases was systematically searched in the Web of Science and China National Knowledge Infrastructure (CNKI) . The search period was from January 1, 2012 to June 1, 2022. CiteSpace software was used to construct a visual graph of early rehabilitation for patients with severe neurological diseases in authoritative databases in both Chinese and English, for agency cooperation, author cooperation, keyword co-occurrence, and keyword clustering analysis.Results:A total of 349 articles were included, including 237 Chinese articles and 112 English articles. According to the search results of CNKI, there were 161 institutions publishing article related to early rehabilitation for patients with severe neurological diseases in China, among which the Nursing Department of Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medicine School had the highest number of publications (4 articles) . The search results of the Web of Science showed that there were 160 institutions publishing article in this field, among which the Florey Institute of Neuroscience and Mental Health in Australia in Australia had the highest number of publications (16 articles) . Foreign researchers mainly focused on the safety assessment and timing of early rehabilitation for patients with severe neurological diseases, while domestic research mainly focused on the evaluation of the effectiveness of different rehabilitation methods on early rehabilitation for patients with severe neurological diseases.Conclusions:The research on early rehabilitation of patients with severe neurological diseases in foreign countries is more in-depth and comprehensive than in China, and there are more multi-center clinical studies, providing a high-level evidence for clinical decision-making. On the basis of existing research results, domestic scholars should focus on strengthening interdisciplinary and inter institutional cooperation, improving the quality and effectiveness of rehabilitation, and fully leveraging the leading role of nurses while collaborating across multiple disciplines.

Dyadic coping is an important psychological and social factor that affects the quality of life of infertility patients and their spouses. Previous studies have mostly focused on the ability of individuals with infertility to cope with diseases, with less involvement in the disease coping abilities of spouses and both spouses. This article reviews the concept, theoretical models, influencing factors, and intervention measures of dyadic coping, in order to provide reference for the research on dyadic coping in infertility patients and their spouses in China.

Osteoporotic vertebral compression fracture (OVCF) can lead to lower back pain and may be even accompanied by scoliosis, neurological dysfunction and other complications, which will affect the daily activities and life quality of patients. Vertebral augmentation is an effective treatment method for OVCF, but it cannot correct unbalance of bone metabolism or improve the osteoporotic status, causing complications like lower back pain, limited spinal activities and vertebral refracture. The post-operative systematic and standardized rehabilitation treatments can improve curative effect and therapeutic efficacy of anti-osteoporosis, reduce risk of vertebral refracture, increase patient compliance and improve quality of life. Since there still lack relevant clinical treatment guidelines for postoperative rehabilitation treatments following vertebral augmentation for OVCF, the current treatments are varied with uneven therapeutic effect. In order to standardize the postoperative rehabilitation treatment, the Spine Trauma Group of the Orthopedic Branch of Chinese Medical Doctor Association organized relevant experts to refer to relevant literature and develop the "Guideline for postoperative rehabilitation treatment following vertebral augmentation for osteoporotic vertebral compression fracture (2022 version)" based on the clinical guidelines published by the American Academy of Orthopedic Surgeons (AAOS) as well as on the principles of scientificity, practicality and advancement. The guideline provided evidence-based recommendations on 10 important issues related to postoperative rehabilitation treatments of OVCF.

In the information age, the use of mobile phones has strengthened people's information exchange. However, excessive mobile phone use will aggravate couples phubbing, which will have a variety of adverse effects on the quality of interpersonal relationships between romantic or married couples, such as reducing intimacy and satisfaction with marriage, and increasing the risk of negative emotions. This paper systematically summarizes the research on phubbing between couples, expounds the concept, influence and theoretical basis of research on phubbing between couples, explores its future research direction, and attempts to provide a basis for future research on phubbing between couples.

【Objective】 To investigate the clinical efficacy and safety of low-dose rituximab combined with dexamethasone in the treatment of refractory ITP (RITP) in children. 【Methods】 A total of 31 RITP children, admitted to the Hematology Department of Kunming Children′s Hospital from January 2016 to December 2019 and agreed to receive low-dose rituximab (100 mg/ time, once a week, for 4 successive weeks) combined with dexamethasone (0.6 mg/kg, once a day, for 4 successive days) were enrolled and studied. Blood routine was monitored every other day during treatment, and adverse drug reactions were recorded. The influence of gender, disease course and age on prognosis was compared by χ² test. 【Results】 1) Among the 31 cases, 11 (35.5%) had platelets >100×10⁹/L after 4 weeks and had no recurrence in 6 months; 9 (29%) had platelets >30×10⁹/L but <100×10⁹/L and had no recurrence in 6 months; 11 (35.5%) showed no recovery of platelets, which were consistently lower than 30×10⁹/L. 2) Rituximab was used in 4 cases (12.9%), 1 case (3.2%) presented with severe drug-induced rashes; Headache, vomiting and elevated blood pressure occurred in 2 cases (6.4%). 1 case (3.2%) presented with laryngeal edema. 3) There was no difference in the total effective rate among different gender, age and disease course (P >0.05). 【Conclusion】 The total effective rate of low-dose rituximab combined with dexamethasone for children with refractory ITP in 6 months is 64.5%, and the adverse reactions are tolerable, so it can be used as a treatment option for children with refractory ITP.