Background/Aims: Metabolic dysfunction–associated steatotic liver disease (MASLD) is a chronic liver disease characterized by hepatic steatosis. Ubiquitin-specific protease 29 (USP29) plays pivotal roles in hepatic ischemiareperfusion injury and hepatocellular carcinoma, but its role in MASLD remains unexplored. Therefore, the aim of this study was to reveal the effects and underlying mechanisms of USP29 in MASLD progression. Methods: USP29 expression was assessed in liver samples from MASLD patients and mice. The role and molecular mechanism of USP29 in MASLD were assessed in high-fat diet-fed and high-fat/high-cholesterol diet-fed mice and palmitic acid and oleic acid treated hepatocytes. Results: USP29 protein levels were significantly reduced in mice and humans with MASLD. Hepatic steatosis, inflammation and fibrosis were significantly exacerbated by USP29 deletion and relieved by USP29 overexpression. Mechanistically, USP29 significantly activated the expression of genes related to fatty acid β-oxidation (FAO) under metabolic stimulation, directly interacted with long-chain acyl-CoA synthase 5 (ACSL5) and repressed ACSL5 degradation by increasing ACSL5 K48-linked deubiquitination. Moreover, the effect of USP29 on hepatocyte lipid accumulation and MASLD was dependent on ACSL5. Conclusions USP29 functions as a novel negative regulator of MASLD by stabilizing ACSL5 to promote FAO. The activation of the USP29-ACSL5 axis may represent a potential therapeutic strategy for MASLD.

Background/Aims: Metabolic dysfunction–associated steatotic liver disease (MASLD) is a chronic liver disease characterized by hepatic steatosis. Ubiquitin-specific protease 29 (USP29) plays pivotal roles in hepatic ischemiareperfusion injury and hepatocellular carcinoma, but its role in MASLD remains unexplored. Therefore, the aim of this study was to reveal the effects and underlying mechanisms of USP29 in MASLD progression. Methods: USP29 expression was assessed in liver samples from MASLD patients and mice. The role and molecular mechanism of USP29 in MASLD were assessed in high-fat diet-fed and high-fat/high-cholesterol diet-fed mice and palmitic acid and oleic acid treated hepatocytes. Results: USP29 protein levels were significantly reduced in mice and humans with MASLD. Hepatic steatosis, inflammation and fibrosis were significantly exacerbated by USP29 deletion and relieved by USP29 overexpression. Mechanistically, USP29 significantly activated the expression of genes related to fatty acid β-oxidation (FAO) under metabolic stimulation, directly interacted with long-chain acyl-CoA synthase 5 (ACSL5) and repressed ACSL5 degradation by increasing ACSL5 K48-linked deubiquitination. Moreover, the effect of USP29 on hepatocyte lipid accumulation and MASLD was dependent on ACSL5. Conclusions USP29 functions as a novel negative regulator of MASLD by stabilizing ACSL5 to promote FAO. The activation of the USP29-ACSL5 axis may represent a potential therapeutic strategy for MASLD.

Background/Aims: Metabolic dysfunction–associated steatotic liver disease (MASLD) is a chronic liver disease characterized by hepatic steatosis. Ubiquitin-specific protease 29 (USP29) plays pivotal roles in hepatic ischemiareperfusion injury and hepatocellular carcinoma, but its role in MASLD remains unexplored. Therefore, the aim of this study was to reveal the effects and underlying mechanisms of USP29 in MASLD progression. Methods: USP29 expression was assessed in liver samples from MASLD patients and mice. The role and molecular mechanism of USP29 in MASLD were assessed in high-fat diet-fed and high-fat/high-cholesterol diet-fed mice and palmitic acid and oleic acid treated hepatocytes. Results: USP29 protein levels were significantly reduced in mice and humans with MASLD. Hepatic steatosis, inflammation and fibrosis were significantly exacerbated by USP29 deletion and relieved by USP29 overexpression. Mechanistically, USP29 significantly activated the expression of genes related to fatty acid β-oxidation (FAO) under metabolic stimulation, directly interacted with long-chain acyl-CoA synthase 5 (ACSL5) and repressed ACSL5 degradation by increasing ACSL5 K48-linked deubiquitination. Moreover, the effect of USP29 on hepatocyte lipid accumulation and MASLD was dependent on ACSL5. Conclusions USP29 functions as a novel negative regulator of MASLD by stabilizing ACSL5 to promote FAO. The activation of the USP29-ACSL5 axis may represent a potential therapeutic strategy for MASLD.

Objective A comprehensive evaluation of oral anticoagulants(OACs)was conducted using the A Quick Guideline for Drug Evaluation and Selection in Chinese Medical Institutions(the Second Edition),to provide a reference for drug selection and clinical medication decisions in medical institutions.Methods Evaluation evidence was collected,and the drugs included in the evaluation were quantified on four dimensions of clinical properties(efficiency and safety),pharmaceutical properties,economy and others.Results All oral anticoagulants included in the evaluation had a score of 70 or higher in the comprehensive evaluation,while warfarin had the highest overall score.Clinical properties and pharmacologic properties were identified as the core attributes for drug selection evaluation.When considering only these factors,edoxaban received the highest score.Conclusion OACs are the preferred option for patients requiring long-term anticoagulation therapy.Various OACs offer distinct clinical advantages.Utilizing the Guidelines(Second Edition)for oral anticoagulant selection and evaluation can offer visual evidence for drug selection and promote the scientific,rational,and safe use of drugs in clinical management.

Objective: To elucidate the differences in manual acupuncture effectiveness at sensitized points by investigating the mechanisms of local skin action at different sensitization points in rats with knee osteoarthritis (KOA). Methods: Forty Sprague–Dawley rats were equally divided into control, model (1 mg of monoiodoacetate into the right knee joint cavity), sham operation, manual acupuncture at right Tianjing acupoint (MAR-SJ 10), and left SJ 10 groups. Safranine-O and fast green staining were used to assess the modeling. The morphological and functional changes in mast cells (MCs) were assessed during acupoint sensitization using toluidine blue and immunofluorescence staining. The levels of serotonin, histamine, substance P (SP), and tryptase at skin acupoints and serum levels of IL-β, IL-6, and TNF-α were detected using ELISA. Results: After 14 days of treatment, the number of MCs and their degranulation rates were statistically higher in the model group than in the control group (both P < .001). After applying acupuncture, the levels of 5-HT, HA, and SP at skin acupoints were lower than those in the model group (all P < .05), and tryptase level was higher (both P < .05). Tryptase level was higher on the skin at the MAL-SJ 10 acupoint than that on the MAR-SJ 10 acupoint (P = .004). Compared with the model group, the serum levels of IL-1β, IL-6, and TNF-α in the MAR-SJ 10 and MAL-SJ 10 groups were lower (all P < .05). Conclusion Acupuncture at KOA-sensitized acupoints mitigates joint injury in KOA rats and may bidirectionally regulate local MCs of these acupoints. This finding not only enhances the reference value of sensitizing points in clinical diagnosis and treatment, but also contributes to the understanding of the biological mechanisms underlying acupuncture intervention at sensitizing points.

Objective To explore the clinical efficacy of Chaiqi Ningshen Anmian Decoction(CNAD)combined with wrist ankle acupuncture(WAA)in treating chronic insomnia(CI)patients with heart and spleen deficiency.Methods CI patients diagnosed and treated at the Beijing Huairou Hospital of Traditional Chinese Medicine from April 2022 to April 2023 were selected,and patients were randomly divided into the Eszolam(ET)group and the combination group(CNAD combined with WAA)according to the random number table method,with 50 cases in each group.The primary outcome was clinical efficacy[evaluated by the Traditional Chinese Medicine Syndrome Integral(TCMSI)].Secondary outcomes included changes in cognitive function[assessed by the Montreal Cognitive Assessment(MoCA)],anxiety level[assessed by the Hamilton Anxiety Scale(HAMA)],sleep quality[assessed by the Pittsburgh Sleep Quality Index(PSQI)],glycated serum albumin(GA),serotonin(5-HT),interleukin-1 β(IL-1β),and C-reactive protein(CRP)before and after treatment in both groups.Results Before treatment,there was no significant differences in total TCMSI between the two groups(P＞0.05).After treatment,the total TCMSI of the combination group was significantly lower than that of the ET group(P＜0.05),and the treatment effectiveness rate was significantly higher in the combination group(P＜0.05).Before treatment,there were no significant differences in MoCA score,HAMA score,PSQI score,serum GA level,serum 5-HT level,serum IL-1 level and serum CRP level between the groups(P＞0.05).After treatment,the MoCA score,serum GA level,and serum 5-HT level in the combination group were significantly higher than those in the ET group(P＜0.05),while the HAMA score,PSQI score,serum IL-1β level,and serum CRP level were significantly lower in the combination group(P＜0.05).Conclusion Compared with ET,CNAD combined with WAA significantly improves insomnia symptoms in CI patients with heart and spleen deficiency,enhances cognitive function and sleep quality,and reduces anxiety levels.This may be related to the upregulation of serum 5-HT,IL-1 β and the inhibition of the inflammatory response.

The graduate course"Principles and Applications of Immunological Technology"at the University of Science and Technology of China abandons the traditional teaching ways of experimental technology courses and focuses on the cultivation of stu-dents'research ethics and styles based on their needs.In the course design,emphasis should be placed on the continuity of the course,and introduces the principles and applications of different experiments through published articles focusing on a single theme to cultivate students'logical thinking and experimental design abilities.The study of the course helps students to quickly adapt the research environment,and guides them to establish correct research concepts and moral standards.The course also teaches standar-dized experimental methods that cultivate good research qualities and rigorous logical thinking,and lays a solid foundation for their future research path.

Objective:To know the current situation of curriculum construction of "Fundamentals of Toxicology" of preventive medicine major in traditional Chinese medicine (TCM) universities.Methods:The undergraduates of preventive medicine major from TCM universities in whole China were selected as the research objects using the cluster sampling method, who took "Fundamentals of Toxicology" course in the 2019-2020 academic year. Questionnaires were compiled and analyzed using descriptive method and radar chart.Results:Six TCM universities were investigated in this study. According to the results, 83.09% (344/414) thought it was necessary to set up the "Fundamentals of Toxicology" course, and the main motivation was to deal with the examination. The agreement rate between the opening semester and the students' wishes was 59.90% (248/414), and the percentages of better satisfaction of theoretical course teaching content, selection of teaching materials and class time were 64.73% (268/414), 55.07% (228/414) and 59.90% (248/414) respectively. The satisfaction rate of experimental course setting, teaching effect and class time was 59.66% (247/414), 62.08% (257/414) and 58.21% (241/414) respectively. It was better to set five times [27.29% (113/414)] or four times [26.81% (111/414)], and four students in each group was the best [53.86% (223/414)]. The most interesting experiment project was bone marrow micronucleus test [29.21% (59/202)], and comprehensive design experiments and highly operable experimental projects should be added. The radar chart of the core knowledge was normal operation type, and there were some differences among students in different schools.Conclusion:There are some differences in the course setting and core knowledge mastery level of the "Fundamentals of Toxicology" course of preventive medicine major in TCM universities. It is necessary to optimize the curriculum construction from opening semester, textbook selection, teaching content, experimental project, etc.

Objective:To explore the predictive value of HACOR score [heart rate (H), acidosis (A), consciousness (C), oxygenation (O), and respiratory rate (R)] on the clinical outcome of non-invasive positive pressure ventilation in patients with pulmonary encephalopathy due to chronic obstructive pulmonary disease (COPD).Methods:A prospective study was conducted. The patients with COPD combined with pulmonary encephalopathy who were admitted to Henan Provincial People's Hospital from January 1, 2017 to June 1, 2021 and initially received non-invasive positive pressure ventilation were enrolled. Besides non-invasive positive pressure ventilation, standard medical treatments were delivered to these patients according to guidelines. The need for endotracheal intubation was judged as failure of non-invasive ventilation treatment. Early failure was defined as the need for endotracheal intubation within 48 hours of treatment, and late failure was defined as the need for endotracheal intubation 48 hours and later. The HACOR score at different time points after non-invasive ventilation, the length of intensive care unit (ICU) stay, the total length of hospital stay, and the clinical outcome were recorded. The above indexes of patients with non-invasive ventilation were compared between successful and failed groups. The receiver operator characteristic curve (ROC curve) was drawn to evaluate the predictive effect of HACOR score on the failure of non-invasive positive pressure ventilation in the treatment of COPD with pulmonary encephalopathy.Results:A total of 630 patients were evaluated, and 51 patients were enrolled, including 42 males (82.35%) and 9 females (17.65%), with a median age of 70.0 (62.0, 78.0) years old. Among the 51 patients, 36 patients (70.59%) were successfully treated with non-invasive ventilation and discharged from the hospital eventually, and 15 patients (29.41%) failed and switched to invasive ventilation, of which 10 patients (19.61%) were defined early failure, 5 patients (9.80%) were late failure. The length of ICU and the total length of hospital stay of the non-invasive ventilation successful group were significantly longer than those of the non-invasive ventilation failure group [length of ICU stay (days): 13.0 (10.0, 16.0) vs. 5.0 (3.0, 8.0), total length of hospital stay (days): 23.0 (12.0, 28.0) vs. 12.0 (9.0, 15.0), both P < 0.01]. The HACOR score of patients at 1-2 hours in the non-invasive ventilation failure group was significantly higher than that in the successful group [10.47 (6.00, 16.00) vs. 6.00 (3.25, 8.00), P < 0.05]. However, there was no significant difference in HACOR score before non-invasive ventilation and at 3-6 hours between the two groups. The ROC curve showed that the area under the ROC curve (AUC) of 1-2 hour HACOR score after non-invasive ventilation for predicting non-invasive ventilation failure in COPD patients with pulmonary encephalopathy was 0.686, and the 95% confidence interval (95% CI) was 0.504-0.868. When the best cut-off value was 10.50, the sensitivity was 60.03%, the specificity was 86.10%, positive predictive value was 91.23%, and negative predictive value was 47.21%. Conclusions:Non-invasive positive pressure ventilation could prevent 70.59% of COPD patients with pulmonary encephalopathy from intubation. HACOR score was valuable to predict non-invasive positive pressure ventilation failure in pulmonary encephalopathy patients due to COPD.

Art therapy plays an important role in enhancing the emotional expression of patients, treating mental and psychological diseases, and promoting the recovery of cancer patients.Due to its extensive meaning and various intervention measures, strengthening the guidance and monitoring of art therapy are important in improving the medical quality of related fields.Clinical practice guidelines are important tools to guide and standardize medical behavior, and also are important guarantees for the implementation effect of medical behavior.Therefore, this article will summarize the current situation of art therapy guidelines, and on this basis, reflect on the formulation and implementation of relevant guidelines and recommendations.