Hepatic stellate cells (HSCs) are the primary fibrogenic cells in the liver, and their activation plays a crucial role in the development and progression of hepatic fibrosis. Here, we report that retinoid X receptor-alpha (RXRα), a unique member of the nuclear receptor superfamily, is a key modulator of HSC activation and liver fibrosis. RXRα exerts its effects by modulating calcium/calmodulin-dependent protein kinase kinase β (CaMKKβ)-mediated activation of AMP-activated protein kinase-alpha (AMPKα). In addition, we demonstrate that K-80003, which binds RXRα by a unique mechanism, effectively suppresses HSC activation, proliferation, and migration, thereby inhibiting liver fibrosis in the CCl₄ and amylin liver NASH (AMLN) diet animal models. The effect is mediated by AMPKα activation, promoting mitophagy in HSCs. Mechanistically, K-80003 activates AMPKα by inducing RXRα to form condensates with CaMKKβ and AMPKα via a two-phase process. The formation of RXRα condensates is driven by its N-terminal intrinsic disorder region and requires phosphorylation by CaMKKβ. Our results reveal a crucial role of RXRα in liver fibrosis regulation through modulating mitochondrial activities in HSCs. Furthermore, they suggest that K-80003 and related RXRα modulators hold promise as therapeutic agents for fibrosis-related diseases.

Objective To observe the value of machine learning model based on MR T2WI and diffusion weighted imaging(DWI)radiomics for predicting perineural invasion(PNI)of rectal cancer.Methods Totally 343 patients with rectal cancer were retrospectively collected and divided into training set(n=275,92 PNI[+]and 183 PNI[-])and test set(n=68,23 PNI[+]and 45 PNI[-])at the ratio of 8∶2.Univariate and multivariate logistic regression(LR)were used to analyze clinical data and screen the independent predictors of PNI in rectal cancer,so as to construct a clinical model.The best radiomics features were extracted and screened based on preoperative T2WI and DWI.Then extremely randomized trees,multilayer perceptron,light gradient boosting machine,extreme gradient boosting,support vector machine(SVM),LR,K-nearest neighbor and random forest algorithms were used to construct ML models,respectively,and the optimal ML model was selected to establish a clinical-radiomics ML model combined with clinical relevant independent predictors.The predictive efficacy and clinical value of each model were evaluated.Results Patients' age was the independent predictor of PNI of rectal cancer(OR=0.988,P＜0.001),and the area under the curve(AUC)of the clinical model constructed based on it was 0.435 and 0.458 in training and test sets,respectively.SVM model was the best one among 8 ML models,with AUC in training and test set of 0.887 and 0.854,respectively.The AUC of clinical-radiomics ML model in training and test sets was 0.887 and 0.860,respectively,not different with AUC of SVM model(both P＞0.05).Decision curve analysis showed that when the threshold value was 0.20-0.45,clinical net benefit of SVM model was higher than that of other models.Conclusion SVM model based on T2WI and DWI radiomics could effectively predict PNI of rectal cancer.

Objective:To evaluate the effect of 5th generation mobile communication technology(5G) remote robot-assisted cholecystectomy on postoperative recovery and quality of life in patients with gallstones.Methods:Clinical data of patients who underwent 5G remote robotic cholecystectomy(20 cases) vs traditional robotic cholecystectomy(20 cases) at Gansu Provincial People's Hospital from May to September 2023 were retrospectively analyzed. Intraoperative and postoperative related indexes were compared between the two groups, and changes in pain analog scores before, 12 hours, and 24 hours after surgery, and global quality of life (GIQLI) scores before and 3 months after surgery were evaluated.Results:There was no significant difference between the two groups in terms of intraoperative and postoperative conditions (intraoperative blood loss, operative time, time to exhaustion, and length of hospital stay). Patients' pain analog scores at 12 and 24 hours postoperatively were lower than preoperatively, but the differences were not statistically significant( P>0.05). In addition, there was no significant difference in recovery indicators between the two groups compared to the control group ( P>0.05). Conclusion:The postoperative recovery metrics of 5G tele-robotic-assisted cholecystectomy were consistent with the results of conventional robotic surgery.

Objective To observe the value of machine learning model based on MR T2WI and diffusion weighted imaging(DWI)radiomics for predicting perineural invasion(PNI)of rectal cancer.Methods Totally 343 patients with rectal cancer were retrospectively collected and divided into training set(n=275,92 PNI[+]and 183 PNI[-])and test set(n=68,23 PNI[+]and 45 PNI[-])at the ratio of 8∶2.Univariate and multivariate logistic regression(LR)were used to analyze clinical data and screen the independent predictors of PNI in rectal cancer,so as to construct a clinical model.The best radiomics features were extracted and screened based on preoperative T2WI and DWI.Then extremely randomized trees,multilayer perceptron,light gradient boosting machine,extreme gradient boosting,support vector machine(SVM),LR,K-nearest neighbor and random forest algorithms were used to construct ML models,respectively,and the optimal ML model was selected to establish a clinical-radiomics ML model combined with clinical relevant independent predictors.The predictive efficacy and clinical value of each model were evaluated.Results Patients' age was the independent predictor of PNI of rectal cancer(OR=0.988,P＜0.001),and the area under the curve(AUC)of the clinical model constructed based on it was 0.435 and 0.458 in training and test sets,respectively.SVM model was the best one among 8 ML models,with AUC in training and test set of 0.887 and 0.854,respectively.The AUC of clinical-radiomics ML model in training and test sets was 0.887 and 0.860,respectively,not different with AUC of SVM model(both P＞0.05).Decision curve analysis showed that when the threshold value was 0.20-0.45,clinical net benefit of SVM model was higher than that of other models.Conclusion SVM model based on T2WI and DWI radiomics could effectively predict PNI of rectal cancer.

Objective:To evaluate the effect of 5th generation mobile communication technology(5G) remote robot-assisted cholecystectomy on postoperative recovery and quality of life in patients with gallstones.Methods:Clinical data of patients who underwent 5G remote robotic cholecystectomy(20 cases) vs traditional robotic cholecystectomy(20 cases) at Gansu Provincial People's Hospital from May to September 2023 were retrospectively analyzed. Intraoperative and postoperative related indexes were compared between the two groups, and changes in pain analog scores before, 12 hours, and 24 hours after surgery, and global quality of life (GIQLI) scores before and 3 months after surgery were evaluated.Results:There was no significant difference between the two groups in terms of intraoperative and postoperative conditions (intraoperative blood loss, operative time, time to exhaustion, and length of hospital stay). Patients' pain analog scores at 12 and 24 hours postoperatively were lower than preoperatively, but the differences were not statistically significant( P>0.05). In addition, there was no significant difference in recovery indicators between the two groups compared to the control group ( P>0.05). Conclusion:The postoperative recovery metrics of 5G tele-robotic-assisted cholecystectomy were consistent with the results of conventional robotic surgery.

Hyperuricemia/gout is a common metabolic disease in China, which is a serious threat to people′s health. In clinical practice, the standardization of prevention and diagnosis and the rate of treat-to-target need to be improved. There is still a lack of education for the patients about the understanding of clinical guidelines, the disease knowledge and the importance of cooperating with doctors to carry out diagnosis and treatment. From the most concerned issues of the patients, we established the hyperuricemia/gout patient practice guideline working group with multidisciplinary physicians and patients. Seventeen opinions, as the hyperuricemia/gout patient practice guidelines, are proposed in accordance with the relevant principles of the "WHO guidelines development manual" , and with the international normative process, aiming to improve the patients compliance, improve the level of health management of the disease.

Interleukin-6(IL-6)is associated with cancer staging, survival, apoptosis and the sensitivity to chemotherapeutic drugs, and it is overexpressed in the cancer tissue and serum of cancer patient.IL-6 Can regulate proliferation and differentiation of cancer cells through IL-6/STAT3 signaling pathway. Therefore, blocking IL-6/STAT3 signaling pathway has potential therapeutic implications for cancer.

Objective To study the effects of siltuximab on the interleukin-6 (IL-6)/signal transducer and activator of transcription 3 (Stat3) signaling pathway in ovarian epithelial carcinoma.Methods (1) Expressions of IL-6 in ovarian cancer patient specimens were assessed by immunohistochemistry.(2) Expression of phosphorylation Stat3 (pStat3) protein in siltuximab and IL-6 treated SKOV3 cell lines was determined by western blot, and expression levels of Stat3-induced bcl-XL,MCL-1, survivin, in siltuximab treated SKOV3/TR and CAOV3/TR cells lines were also determined by western blot.(3) Real-time image analysis was used to study the nuclear translocation of pEGFP-Stat3 fusion protein in ovarian cancer cell line SKOV3-pEGFP-Stat3 treated with siltuximab and IL-6.(4)Paclitaxel sensitivity in siltuximab treated SKOV3/TR and CAOV3/TR cell lines were assessed using the methyl thiazolyl tetrazolium (MTT).The 50% inhibiting concentration ( IC50 ) was defined as the paclitaxel concentration required to decrease the A490 value to 50%.Results ( 1 ) There were significantly difference in IL-6 staining density and the positive rate of IL-6 protein stained among the metastatic, and drug-resistant recurrent tumors,and matched primary tumors [69%(18/26)] vs.77% (20/26)vs.23% (6/26), P＜0.05].(2)A clear increase in Stat3 phosphorylation levels was observed in the IL-6-treated SKOV3 cell lines as compared to the SKOV3 cell lines.When the IL-6-treated SKOV3 cells were incubated with siltuximab with a range of concentrations of 0.001,0.01,0.1, 1.0 and 10 μg/ml, there were trends toward reduced pStat3 expression in the treated cell lines.Compared without treatment with siltuximab, the expression of the anti-apoptotic proteins MCL-1, bcl-XL and survivin in SKOV3/TR and CAOV3/TR cell lines were significantly decreased after treated with siltuximab.(3) In resting cells, the majority of pEGFPStat3 was cytoplasmic until the addition of human IL-6, which promptly induced the translocation of fluorescent Stat3 molecules to the nucleus.Exposure of cells to siltuximab with a range of concentrations of 0.001, 0.01,0.1, 1.0 and 10 μg/ml, followed by an incubation in IL-6 significantly reduced pEGFP-Stat3 nucleocytoplasmic translocation.(4) MTT cytotoxicity assay demonstrated that siltuximab increased paclitaxel-induced cell death and partially overcame paclitaxel resistance.Treated with siltuximab ( 1 and 10 μg/ml) ,the paclitaxel IC50 value of siltuximab in SKOV3/TR (0.49, 0.19 μg/ml) and CAOV3/TR (0.0010, 0.0008 μg/ml) cells were significantly lower than those in untreated cells (0.71,0.0021 μg/ml;all P ＜ 0.05).Conclusions These results demonstrated that siltuximab effectively block the IL-6 signaling pathways, which .Blockage of IL-6 signaling may provide benefits for the treatment of ovarian cancer.

Objective To discuss the technology of modest isolating and enriching the intestinal epithelial stem cells. Methods Mouse intestinal epithelial cells were stained by Rhodamine 123 (Rho), sorting the Rhodamine 123 low staining cell population ( Rholow ) and Rhodamine 123 strong straining cell population ( Rhobri ) by fluorescence activated cell sorting(FACS) in flow cytometer; Detecting the musaashi-1 and p-glycoprotein 1 (p-g-p1) mRNA expression of two groups by RT-PCR; Analyzing the cell cycle and the percentage of the musashi-1 positive cells by flow cytometry. Results The intestinal epithelial cells were divided into three groups, Rhodamine 123 low staining cells( 12. 34% of total cells), Rhodamine 123 middle staining cells (45.26% of total cells) and Rhodamine 123 strong staining cells ( 41. 40% of total cells). The Rholow cell fraction and Rhobri cell fraction were isolated successfully. Both of musashi-1 and p-g-p1 mRNA were strongly expressed in Rho1ow cell fraction, and Rhobri cell fraction little expressed p-g-p1 mRNA. Most of Rho1ow cells were in G0/G1 phase, and the musashi-1 positive cells were about 10.37% of total cells in this fraction. Conclusion The intestinal epithelial stem cells can be modestly isolated and enriched by Rhodamine 123 staining.