ObjectiveTo investigate the disease burden of non-alcoholic fatty liver disease （NAFLD） among young people in East Asian countries （including China， North Korea， Japan， Mongolia， and South Korea） in 1990—2023， and to provide a basis for formulating and adjusting the prevention and treatment strategies for NAFLD. MethodsRelated disease burden data of NAFLD among the young people in these five East Asian countries were collected from the Global Burden of Disease 2023 （GBD 2023） database， including incidence rate， prevalence rate， and disability-adjusted life years （DALY）， and the young people were divided into groups based on country， sex， and age. Estimated annual percentage change （EAPC） was used to comprehensively evaluate the changing trend of the disease burden of NAFLD among young people from 1990 to 2023， and the Autoregressive Integrated Moving Average model was used to predict the disease burden of NAFLD among the young people in China. ResultsIn 2023， the standardized incidence rates of NAFLD among the young people in China， North Korea， Japan， Mongolia， and South Korea were 926.57/100 000， 805.83/100 000， 412.66/100 000， 747.66/100 000， and 534.08/100 000， respectively； the standardized prevalence rates of NAFLD among the young people in China， North Korea， Japan， Mongolia， and South Korea were 16 817.94/100 000， 14 500.98/100 000， 8 534.40/100 000， 13 705.28/100 000， and 11 587.93/100 000， respectively； the standardized DALY rates of NAFLD among the young people in China， North Korea， Japan， Mongolia， and South Korea were 6.34/100 000， 10.18/100 000， 5.23/100 000， 47.93/100 000， and 6.76/100 000， respectively. From 1990 to 2023， there was a tendency of increase in the standardized incidence rate of NAFLD among the young people in China， North Korea， Japan， Mongolia， and South Korea， with an EAPC of 0.87%， 0.52%， 0.26%， 0.48%， and 0.87%， respectively； there was also a tendency of increase in the standardized prevalence rate of NAFLD among the young people in China， North Korea， Japan， Mongolia， and South Korea， with an EAPC of 0.99%， 0.49%， 0.24%， 0.59%， and 0.93%， respectively； conversely， there was a tendency of reduction in the standardized DALY rate of NAFLD among the young people in China， Japan， Mongolia， and South Korea， with an EAPC of -2.21%， -2.01%， -0.37%， and -4.62%， respectively， while the standardized DALY rate of NAFLD among the young people in North Korea remained relatively stable， with an EAPC of -0.01%. The subgroup analysis based on sex showed that there was a significant difference in the disease burden of NAFLD between the young people with different sexes in the five East Asian countries， and the subgroup analysis based on age showed that the incidence rate of NAFLD in young people decreased with the increase in age， while the prevalence rate and DALY rate of NAFLD increased with age. In addition， the standardized incidence rate and standardized prevalence rate of NAFLD among Chinese young people would further increase in the future， while there would be a reduction in standardized DALY rate in the future. ConclusionThere is a significant difference in the disease burden of NAFLD in young people across different countries， sexes， and age groups. In the future， targeted prevention and treatment measures should be developed based on the distribution characteristics of the disease burden of NAFLD， in order to effectively reduce the disease burden of NAFLD among young people.

Critical care medicine(CCM)is a multifaceted discipline challenged by the inherent heterogeneity and complexity of critical illnesses.Establishing precise,standardized diagnostic and therapeutic systems has emerged as a crucial challenge requiring urgent resolution in this field.Surgical critical care,a pivotal branch of CCM,plays an indispensable role in managing patients with severe trauma,postoperative intra-abdominal infections,solid organ transplantation,and other life-threatening conditions.Evidence-based,etiology-guided therapy serves as the cornerstone of surgical critical care,where accurate identification and timely interventions constitute vital determinants for enhancing patient survival rates and improving prognoses.This article proposes an innovative diagnostic and therapeutic paradigm termed the urgency/physics-biology-chemistry(U/P-B-C)model.Built upon the established principle of urgent(urgency,U)life support in surgical critical care,this model emphasizes a novel conceptual framework centered on etiology-based(physics-biology-chemistry,P-B-C)diagnosis and treatment.Implementing the U/P-B-C innovative diagnostic and therapeutic model in surgical critical care facilitates precise identification of the fundamental pathological mechanisms underlying critical clinical conditions with complex and dynamic clinical environments,enables systematic clarification of clinical reasoning,and ultimately supports evidence-informed decision-making.Its core objectives encompass enhancing surgical intensivists' diagnostic-therapeutic capabilities and ensuring rigorous adherence to the principle of etiology-guided therapy,thereby providing both theoretical foundation and practical guidance for improving the success rate of patient resuscitation and optimizing prognosis in surgical critical care settings.

Objective To observe the effects of Yinqin Qingfei Granules on oxidative injury in lung tissue of mice with mycoplasma pneumoniae infection;To explore the mechanism of the Keap1/Nrf2/HO-1 signaling pathway in it.Methods Totally 100 BALB/c mice were randomly divided into blank group,model group,Yinqin Qingfei group,Azithromycin group and combination group,with 20 mice in each group.Except for the blank group,the other groups of mice were used to establish mycoplasma pneumoniae pneumonia model through bacterial solution nasal drip,and the blank group was given the same amount of normal saline nasal drip for 3 days.After modeling,the drug groups were given corresponding drugs by gavage,the blank group and the model group were given the same amount of distilled water by gavage,and the materials were taken at 3 and 7 days after administration,respectively.HE staining was used to observe the morphology of lung tissue,ELISA was used to detect the contents of interleukin(IL)-1β and tumor necrosis factor(TNF)-α in serum,biochemical method was used to detect the contents of nitric oxide(NO),malondialdehyde(MDA),superoxide dismutase(SOD)and glutathione(GSH)in lung tissue,Western blot was used to detect the expressions of Kelch like ECH associated protein 1(Keap1),nuclear factor E2 related factor 2(Nrf2)and heme oxygenase-1(HO-1)protein in lung tissue.Results Compared with the blank group,the lungs of mice in the model group showed severe inflammatory changes on day 3 and 7,with alveolar fusion or disappearance,and lung consolidation,which were more severe on day 7;the contents of IL-1β and TNF-α in serum significantly increased(P<0.05),the contents of SOD and GSH in lung tissues significantly decreased(P<0.05),and the contents of MDA and NO significantly increased(P<0.05),the protein expression of Keap1 in lung tissues increased(P<0.05),and Nrf2 and HO-1 protein expressions decreased(P<0.05).Compared with the model group,the histopathological changes in lung tissue showed different degrees of improvement on day 3 and 7 of drug treatment in Yinqin Qingfei group,Azithromycin group and combination group groups,the serum contents of IL-1β and TNF-α were significantly decreased(P<0.05),the contents of SOD and GSH in lung tissue were significantly increased on day 7 of drug treatment(P<0.05),the contents of MDA and NO significantly decreased(P<0.05),the protein expression of Keap1 in lung tissue decreased on day 3 and 7 of drug treatment(P<0.05),and the protein expressions of Nrf2 and HO-1 increased(P<0.05).Conclusion Yinqin Qingfei Granules can regulate the level of inflammatory factors,reduce lung inflammation and oxidative damage of mice with mycoplasma pneumoniae infection.The mechanism may be related to down-regulating the expression of Keap1,up-regulating the expressions of Nrf2 and HO-1,reducing the contents of NO and MDA,improving the activities of SOD and GSH,and playing an antioxidant role.

Ferroptosis is a form of programmed cell death characterized by overwhelmed lipid oxidation, and it has emerged as a promising strategy for cancer therapy. Enhanced ferroptosis could overcome the limitations of conventional therapeutic modalities, particularly in difficult-to-treat tumors. In this study, we developed a dual-modality therapy in nanomedicine by combining paclitaxel (PTX) chemotherapy and pyropheophorbide-a (Ppa) phototherapy. Heparin (HP) was grafted with poly(N-(2'-hydroxy) propyl methacrylamide) (pHPMA) using reversible addition-fragmentation chain transfer polymerization to form HP-pHPMA (HH), which was utilized to deliver Ppa and PTX, yielding HP-pHPMA-Ppa (HH-Ppa) and HP-pHPMA-PTX (HH-PTX), respectively. The prodrug-based combinational nanomedicine (HH-PP) was formed by co-assembly of HH-PTX and HH-Ppa. It was found that HH-PP treatment significantly disrupted lipid metabolism in triple-negative breast cancer (TNBC) cells, induced extensive lipid oxidation, and promoted ferroptosis. In vivo, HH-PP intervention achieved a tumor growth inhibition rate of 86.63% and activated adaptive immunity with an elevated CD8⁺ cytotoxic T cell infiltration level. This combinational nanomedicine offers a promising platform for co-delivery of multiple therapeutic agents. It exerts a promising anti-tumor effect via enhanced ferroptosis and ferroptosis-induced immune activation by disrupting lipid metabolism in TNBC cancer cells.

Purpose To explore the diagnostic efficacy of texture analysis in grading multiple ligament injuries of the knee Joint.Materials and Methods MRI images of 203 patients with knee injuries in the Second Affiliated Hospital of Shantou University School of Medicine from June 2018 to September 2020 were retrospectively collected,and then graded the injuries of multiple ligaments.Extraction of texture features and discriminant analysis were accomplished by MaZda software.Spearman correlation analysis and LASSO penalized Logistic regression analysis were used to further explore the differential diagnostic efficacy of each texture parameter for grading knee ligament injuries.Results(1)MaZda software was found to have the highest diagnostic efficacy for patellar ligament injury grading by using different texture feature screening methods in combination with discriminant analysis.Non-linear discriminant analysis had the lowest misclassification rate of 4.43%.(2)The texture parameters that were ultimately included in the analysis of the subjects'work characteristic curves appeared more frequently in the gray level co-occurrence matrix and the run length matrix.(3)The area under the curve of the texture parameters finally included in the analysis were 0.870-0.975,0.772-0.912,0.836-0.929 and 0.766-0.920,respectively in patellar ligament,anterior cruciate ligament,posterior cruciate ligament and lateral collateral ligament for the diagnosis of knee ligament injury grading.The diagnostic efficacy for patellar ligament injury grading was the highest,which was consistent with the lowest misclassification rate for patellar ligament in the discriminant analysis of texture features.And the texture parameters ultimately included in patellar ligament were all highly correlated with its injury grading.Conclusion The texture analysis technique has high diagnostic efficacy for grading knee ligament injuries,and can provide a more accurate diagnostic imaging basis for the clinic.

Objective:To investigate the effects of circular RNA circ_0086376 on the expression of acne-related inflammatory factors by targeting microRNA (miR) -5195-3p.Methods:Circ_0086376-overexpressing or -interferred stable HaCaT cell lines were constructed and co-cultured with Propionibacterium acnes ( P.acne). Quantitative real-time PCR was used to detect the effect of co-culture on circ_0086376 expression, while enzyme-linked immunosorbent assay (ELISA) was performed to measure the expression of inflammatory factors in the cell culture supernatant. The overexpression or interference of circ_0086376 plasmid and lentivirus mimicking or inhibiting miR-5195-3p fragment were transfected into HaCaT cells, and ELISA was used to detect the expression of inflammatory factors in the culture supernatant of HaCaT cells after overexpression or interference of circ_0086376 cultured alone or with P.acne. The luciferase reporter assay was conducted to verify the targeting relationship between circ_0086376 and miR-5195-3p. Additionally, ELISA was used to detect the effects of overexpression/interference of circ_0086376 and mimic/inhibition of miR-5195-3p on the expression of inflammatory factors in the culture supernatant of HaCaT cells co-cultured with P.acne. Results:After co-culture with P.acne, the levels of inflammatory factors in the culture supernatant were significantly higher than those in the HaCaT cells cultured alone, including Interleukins (IL) -1β ([355.80 ± 23.20] vs. [260.50 ± 16.58] pg/ml, t = 5.79, P < 0.01), IL-6 ([38.04 ± 2.69] vs. [14.33 ± 0.75] pg/ml, t = 14.65, P < 0.01), IL-12 ([10.87 ± 0.78] vs. [6.52 ± 0.77] pg/ml, t = 6.89, P < 0.01), IL-18 ([222.60 ± 21.07] vs. [146.10 ± 9.14] pg/ml, t = 5.77, P < 0.01), and Tumor necrosis factor (TNF) -α ([50.39 ± 1.29] vs. [20.46 ± 0.83] pg/ml, t = 33.83, P < 0.01). The expression levels of IL-1β, IL-6, IL-12, IL-18 and TNF-α in the culture supernatant of HaCaT cells in the circ-empty vector + P.acne group were higher than those in the circ-empty vector overexpression group. The levels of inflammatory factors mentioned above in circ-overexpression + P.acne group were lower than those in circ-overexpression empty vector + P.acne group ( P < 0.01). The expression levels of inflammatory factors mentioned above in the culture supernatant of HaCaT cells in the interference circ-empty vector + P.acne group were higher than those in the interference circ-empty vector group. Compared with the interference circ-empty vector + P.acne group, the expression of circ in the interference circ + P.acne group was higher ( P < 0.01). Luciferase reporter assay confirmed that circ_0086376 could bind to miR-5195-3p. The expression levels of IL-1β, IL-6, IL-12, IL-18 and TNF-α in the circ-overexpression group were lower than those in the empty vector group ( P < 0.05), and the levels of these inflammatory factors in the circ-overexpression + miR mimic group were higher than those in the circ overexpression group ( P < 0.05). The expression levels of inflammatory factors in the interference circ group were higher than those in the empty vector group, levels of inflammatory factors in the circ + miR-inhibiting group were lower than those in the circ interference group ( P < 0.05) . Conclusion:Circ_0086376 can inhibit the expression of acne-related inflammatory factors by targeting and downregulating miR-5195-3p.

Objective:To study the effect of traditional Chinese medicine (TCM) formula in the treatment of brucellosis.Methods:Patients with brucellosis who were treated at the Beidahuang Industry Group General Hospital from March to November 2024 were selected and their clinical data were collected. A case-control study was conducted, thirty patients treated with conventional therapy plus TCM formula were selected as the TCM group, and 35 patients treated with conventional therapy were selected as the control group. Blood routine, C-reactive protein (CRP), lymphocyte subsets (CD45 +, CD3 +, CD4 +, CD8 +, CD19 +), and related cytokines [interleukin (IL)-6, IL-10] were determined before and after treatment to observe the clinical effect of TCM formula in the treatment of brucellosis. Survival curve was draw, and Log-Rank test was used to compare the differences in clinical symptom relief time between the two groups of patients. Results:Compared with pre-treatment, there were statistically significant differences in the numbers of CD45 +, CD3 +, CD4 +, CD8 +, CD19 + lymphocytes, neutrophil (NEUT), and the levels of CRP, IL-6, and IL-10 in the TCM group after treatment ( P < 0.05). After treatment, the comparison of each index between the two groups showed that there were statistically significant differences in the numbers of CD45 +, CD3 +, CD4 +, and CD8 + lymphocytes [control group vs TCM group: 2 470.00 (1 895.50, 3 207.00) vs 1 991.00 (1 720.75, 2 367.25), 1 920.00 (1 364.50, 2 428.00) vs 1 591.00 (1 343.00, 1 884.00), 1 021.00 (785.00, 1 205.50) vs 839.50 (704.25, 1 010.25), (686.42 ± 294.47) vs (596.97 ± 205.32) pieces/μl, P < 0.05]. There was no statistically significant difference in the number of CD19 + lymphocytes, NEUT, and the levels of CRP, IL-6 and IL-10 ( P > 0.05). The Log-Rank test results showed that there were statistically significant differences in the relief time of hyperhidrosis and night sweats ( P = 0.016), fatigue ( P = 0.016), and muscle soreness ( P = 0.004) between the two groups of patients. Conclusion:TCM formula has certain effects in the adjuvant therapy of brucellosis, which can improve the immune function of lymphocytes and relieve clinical symptoms, and has clinical application value.

Objective:To explore the clinical characteristics of patients with brucellosis complicated with epididymo-orchitis (Brucellar epididymo-orchitis, BEO), so as to provide reference for clinical diagnosis and treatment of BEO.Methods:General and clinical data of 293 male patients with acute brucellosis admitted to the Beidahuang Industry Group General Hospital from January 2023 to December 2024 were retrospectively collected. They were divided into a BEO group (30 cases) and a non-BEO group (263 cases) based on the presence or absence of epididymo-orchitis. Epidemic characteristics, clinical manifestations and laboratory examination results were compared and analyzed.Results:Among 293 male patients with acute brucellosis, the incidence of BEO was 10.24% (30/293). Their age was mainly concentrated in 45 - < 60 years old (53.33%, 16/30), and occupation was mostly farmers (63.33%, 19/30). There were no statistically significant differences in the distribution of age, occupation, exposure history and onset season between the BEO group and the non-BEO group ( P > 0.05). The distribution of abdominal pain and urinary frequency/urgency/pain symptoms was compared, and the differences were statistically significant ( P < 0.05). White blood cell count (WBC), neutrophil count (NEUT), and C-reactive protein (CRP) levels in the BEO group were higher than those in the non-BEO group ( P < 0.05), while the levels of cytokines interleukin (IL)-6 and interferon-γ (IFN-γ) were lower than those in the non-BEO group ( P < 0.05). After 6 - 8 weeks of hospitalization, the levels of WBC, NEUT, CRP, albumin, alanine aminotransferase, aspartate aminotransferase, γ-glutamyl transpeptidase, alkaline phosphatase, α-hydroxybutyrate dehydrogenase, lactate dehydrogenase, IL-4, IL-6, IL-10, IL-17, tumor necrosis factor-α, and IFN-γ in patients of the BEO group were significantly different from before treatment ( P < 0.05). Twenty-eight patients were cured, 1 patient underwent orchiectomy, and 1 patient experienced recurrence. Conclusions:Middle-aged male patients with brucellosis are more prone to BEO. Clinical manifestations and laboratory tests have certain diagnostic value for BEO. Suspected BEO patients should be diagnosed and treated as early as possible to reduce the occurrence of adverse prognosis.

Objective:To learn about the clinical characteristics of patients with neurobrucellosis (NB) and provide references for clinical diagnosis and treatment of NB.Methods:The clinical data of 22 NB patients diagnosed and treated at Beidahuang Industry Group General Hospital from January 2018 to November 2024 and 178 healthy individuals undergoing physical examinations during the same period were retrospectively collected. The epidemiological characteristics, clinical manifestations, laboratory tests, treatment and prognosis of NB patients were analyzed.Results:Among the 22 NB patients, 12 were males (54.55%) and 10 were females (45.45%). The age was (51.77 ± 12.75) years old, ranging from 27 to 80 years old. Most of the patients were farmers (95.45%, 21/22), and 16 cases (72.73%) had contacted with cattle/sheep. The onset seasons were mainly in summer (40.91%, 9/22) and spring (31.82%, 7/22). Among all NB patients, there were 10 cases of encephalitis/meningoencephalitis, 9 cases of myelitis, and 3 cases of meningitis. The general symptoms were mainly fever (68.18%, 15/22), the neurological symptoms were mainly nausea and vomiting (36.36%, 8/22), and the physical signs were mainly muscle weakness (50.00%, 11/22) and pathological signs (45.45%, 10/22). The laboratory test results showed that the levels of hemoglobin, hematocrit, C-reactive protein, total protein, albumin, γ-glutamyl transpeptidase, α-hydroxybutyric acid dehydrogenase, lactate dehydrogenase, and glutathione reductase in NB patients were significantly different from those in healthy individuals ( P < 0.001). Brain magnetic resonance imaging revealed ischemic changes in 5 cases (22.73%), abnormal brain signals in 2 cases (9.09%), and demyelinating lesions in white matter in 1 case (4.55%). After treatment, 18 NB patients were followed up and showed good prognosis, with only 2 cases exhibiting varying degrees of sequelae (walking disorders or memory impairment). Conclusions:The clinical manifestations of NB patients are diverse. A comprehensive judgment should be made by combining epidemiological characteristics, clinical manifestations, laboratory tests and imaging examinations.

Objective To explore the correlation between helicobacter pylori(Hp)infection and inflam-matory factors,as well as its association with the progression of liver fibrosis in patients with metabolically associ-ated fatty liver disease(MAFLD)and type 2 diabetes mellitus(T2DM).Methods A total of 300 patients diag-nosed with MAFLD and T2DM who were admitted to the Hepatology Department of Hebei Hospital of Traditional Chinese Medicine between April 2023 and March 2024 were recruited.Based on Hp infection status,these patients were classified into an Hp-positive group and an Hp-negative group.Subsequently,the clinical data,inflammatory factors,and liver fibrosis indices of the two groups were comprehensively compared.Furthermore,the patients in the Hp-positive group were randomly assigned to an intervention group and a control group.The intervention group received standard Hp eradication therapy,whereas the control group was administered placebo therapy.Pearson correlation analysis was employed to investigate the associations among Hp infection,inflammatory factors,and liver fibrosis indices.Binary logistic regression analysis was utilized to identify the independent risk factors influencing the progression of liver fibrosis.Results In both the Hp-positive and Hp-negative groups,parameters including age,fasting blood glucose(FPG),glycosylated hemoglobin(HbA1c),total bilirubin(TBIL),direct bilirubin(DBIL),indirect bilirubin(IBIL),tumor necrosis factor-α(TNF-α),and interleukin-6(IL-6),along with C-reactive protein(CRP)and liver stiffness measurement(LSM),were meticulously measured.Statistical analysis revealed that the differences in these parameters between the two groups were significant(P<0.05).Specifically,within the experimental setup,the levels of TNF-α,IL-6,CRP,and LSM in the intervention group were notably lower than those in the control group(P<0.05).Pearson correlation analysis was employed to explore the relation-ships among variables,and the results indicated a positive correlation between the Hp detection value(DPM)and the levels of TNF-α,IL-6,CRP,and LSM(P<0.05).Furthermore,binary logistic regression analysis was con-ducted to identify independent risk factors.The findings demonstrated that positive Hp infection,elevated TNF-α,elevated IL-6,and elevated CRP were independent risk factors for the progression of liver fibrosis(P<0.05).To evaluate the diagnostic performance,the receiver operating characteristic(ROC)curve analysis was carried out.The areas under the curve(AUC)for HP infection,TNF-α,IL-6,and CRP were 0.800,0.786,0.769,and 0.783,respectively.These values were significantly lower than the AUC of 0.896 obtained from the combined detection(P<0.05).Conclusions In MAFLD patients with T2DM,DPM is closely associated with inflammatory factors(such as TNF-α,IL-6,and CRP)and the advancement of liver fibrosis.The combined detection of these factors holds significant value in predicting the progression of liver fibrosis.It can offer a reliable foundation for the clinical assessment of the risk of liver fibrosis progression.