Objective: To investigate the ameliorative effect of kidney bean enzyme crude extract (KBECE) on non-alcoholic fatty liver disease (NAFLD) in mice. Methods: Total of 30 female ICR mice were randomly divided into 10 mice fed with normal diet (normal group), and the other 20 mice were fed with 45% high fat diet to establish the model of NAFLD. After 2 weeks, they were randomly divided into high fat diet control group (high fat group) and KBECE intervention group (intervention group), with 10 mice in each group. The mice were treated with PBS and KBECE daily for 6 weeks, and the body weight was recorded every week. At the 8th week, the mice were sacrificed and the blood and liver tissue were collected. The pathological changes of liver of NAFLD mice were observed by HE and Masson staining. The contents of MDA in liver tissue, TG, TC and LDL-C in serum were measured by commercial kits. Results: KBECE decreased the relative growth rate of body weight of mice, KBECE could improve hepatic steatoid degeneration and fibrosis in hyperlipidemic mice. Compared with the high fat group, the liver index of the intervention group decreased respectively (P<0.05), the content of MDA in liver tissue and the content of TG, TC, LDL-C in serum decreased respectively (all P<0.05). Conclusion: KBECE can improve the NAFLD induced by high fat diet by repairing the disorder of lipid metabolism and inhibiting oxidative stress.

Objective: To explore the effect of Bupleurum extract on non-alcoholic fatty liver disease (NAFLD) and its relationship with amine oxidase copper-containing 3 (AOC3)-phosphatidylinositol 3-KINASE (PI3K)/protein kinase B (AKT) signaling pathway. Methods: A total of 69 patients with NAFLD in Zhenjiang Hospital of Chinese Traditional and Western Medicine from May 2022 to May 2023, and another 70 healthy controls were enrolled in the study. The contents of phenylalanine (Phe) and tyrosine (Tyr) in serum were measured by ELISA. The relative expressions of AOC3 mRNA and protein in serum were detected by qRT-PCR and Western blotting, respectively. The NAFLD model of C57BL/6 mice was constructed. After modeling, they were divided into control group, model group, and low-dose group (50 mg/kg), medium-dose group (75 mg/kg), and high-dose group (100 mg/kg) of Bupleurum extract, with 6 mice in each group. The Bupleurum extract group was given the corresponding Bupleurum extract, the control group and the model group were given corresponding volumes of normal saline by gavage every day, respectively. Four weeks later, the contents of total cholesterol (TC), triglyceride (TG), and high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), nitric oxide (NO), and tumor necrosis factor-alpha (TNF-α) in serum were detected by ELISA. Additionally, superoxide dismutase (SOD) activity and malondialdehyde (MDA) levels in liver tissues were measured. Hepatic pathology was evaluated by hematoxylin-eosin (HE) staining. The siRNA2 (50 nmol/L) was screened out by knocking down the expression of AOC3 by siRNA transfection. Hepatocytes were divided into control group, model group, siRNA2 group (50 nmol/L), Bupleurum group (100 μg/mL), and combined group (50 nmol/L siRNA2 + Bupleurum 100 μg/mL). The cell proliferation rate, apoptosis rate and the protein expressions of p-PI3K and p-AKT were detected by MTT, flow cytometry and Western blotting, respectively. Results: The contents of Phe and Tyr in the serum of patients with NAFLD and model mice, as well as the relative expression levels of AOC3 mRNA and protein, were significantly higher than those of healthy individuals and the control group, respectively (P<0.01). Compared with the model group, the levels of Phe, Tyr, TC, TG, LDL-C, NO and TNF-α in the serum of mice in the medium and highdose Bupleurum groups were significantly decreased (P<0.05 or P<0.01), the level of HDL-C was significantly increased (P<0.01), and liver fibrosis and reactive oxygen species accumulation were significantly attenuated (P<0.01). Compared with the siRNA2 group and the Chaihu group, the proliferation rate of hepatocytes in the combined group was significantly increased (P<0.01), the apoptosis rate was greatly decreased (P<0.01), the contents of lipotoxic metabolites (TG, TC) were significantly decreased (P<0.01), and oxidative stress was significantly inhibited (decreased content of MDA, increased SOD/GSH-Px, P<0.01 or P<0.05), liver function was significantly improved (decreased contents of ALT and AST, P<0.01), and the PI3K/AKT signaling pathway was activated (the expressions of AOC3, p-PI3K, and p-AKT decreased, P<0.01). Conclusion: Bupleurum extract may attenuate NAFLD by regulating the metabolism of amino acids related to NAFLD, reducing the content of peroxides, blocking the excessive activation of the PI3K/AKT pathway mediated by AOC3, reducing the expression of AOC3 and phosphorylating the expression of PI3K/AKT.

Objective: Investigating the inhibitory effects of sodium butyrate (NaB) on oleic acid (OA) and advanced glycation end-products (AGEs), and exploring its impact and mechanism on lipid deposition and inflammatory response in HepG2 cells. Methods: HepG2 cells were divided into 5 groups: control group (NC), cells without any treatment; OA group, cells treated with 0.05 mmol/L OA for 2 h; OA+AGEs group, cells co-treated with 0.05 mmol/L OA and 200 μg/mL AGEs for 2 h; OA+AGEs+low concentration NaB group (NaB-L), OA+AGEs+high concentration NaB group (NaB-H), where NaB-L group and NaB-H group cells were pre-treated with concentrations of 100 μmol/L and 400 μmol/L NaB for 24 h, then treated with 0.05 mmol/L OA and 200 μg/mL AGEs for 2 h. qRT-PCR was used to detect the mRNA expressions of inflammatory factors, mitochondrial autophagy-related genes, and cholesterol metabolism-related genes. Western blotting was used to detect the expressions of LC3-Ⅱ and P62, as well as the distribution of cytochrome C (CytoC) in mitochondria and cytoplasm; flow cytometry was used to detect cellular reactive oxygen species (ROS) and mitochondrial membrane potential levels. Results: Compared to the NC group, lipid deposition in the cells, the NLRP3, Caspase-1, IL-1β, HMGR mRNA, P62, cytoplasmic CytoC expression levels, and ROS levels in the OA+AGEs group were significantly increased (P<0.05), while the LDLR, PINK1, Parkin mRNA expression levels and mitochondrial membrane potential was significantly decreased (P<0.05), as well as the expression levels of CytoC in mitochondria, and LC3-Ⅱ (P<0.05). Compared to the OA+AGEs group, both low and high concentrations of NaB significantly reduced lipid deposition in the cells, the expressions of NLRP3, Caspase-1, IL-1β, HMGR mRNA, P62, cytoplasmic CytoC and ROS levels  (P<0.05), while significantly increased the expression of LDLR, PINK1, Parkin mRNA and mitochondrial membrane potential (P<0.05), as well as the expressions of CytoC in mitochondria, LC3-Ⅱ(P<0.05). Conclusion: NaB enhances mitophagy via the PINK1/Parkin pathway, reducing ROS accumulation and CytoC release, thereby suppressing OA/AGEs-induced lipid deposition and inflammatory response.

非酒精性脂肪性肝病(non-alcoholic fatty liver disease，NAFLD)是目前我国最常见的慢性肝病，前期无明显临床症状，多于体检时发现肝功能化学指标的改变。随着病情进展，NAFLD会出现不可逆性的肝损伤，如不加以规范治疗，后期易导致肝纤维化和肝癌。棕榈油酸是一种广泛存在于自然界的单不饱和脂肪酸。近来研究发现，棕榈油酸是体内固有的脂质调节因子，具有包括改善胰岛素抵抗、维持脂质稳态以及减少组织炎症等功能，其在防治NAFLD方面具有独特的自身优势。因此，本文对棕榈油酸防治NAFLD的四大途径进行归纳并予以综述。

目的： 分析脑损伤早产儿脑血流动力学变化及早产儿脑损伤的相关影响因素。方法： 选择2018年6月至2022年12月在江苏大学附属医院分娩的胎龄小于37周的单胎早产儿80例，其中脑损伤组27例，无脑损伤组53例。对比两组早产儿的脑血流动力学变化情况，分析早产儿脑损伤的危险因素。结果： 脑损伤组的动脉血流助力指数（RI）和动脉血流搏动指数（PI）高于无脑损伤组，而动脉舒张期血流速度（Vd）、动脉收缩期血流速度峰值（Vs）、动脉血流平均速度（Vm）则明显低于无脑损伤组（P均<0.05）。差异性分析结果表明，与无脑损伤组比较，早产儿脑损伤组胎龄、出生时体重、机械通气、高危因素、1 min及5 min Apgar评分、酸中毒及血糖水平差异有统计学意义（P<0.05）；多因素Logistic回归分析结果表明，上述指标均为早产儿脑损伤的影响因素。结论： 脑血流动力学相关指标为临床诊断早产儿脑损伤提供一定的依据，关注相关影响因素可及时预防和减少脑损伤发生率。

目的： 探讨经阴道分娩前纤维蛋白原(fibrinogen,Fib)和中性粒细胞delta指数(delta neutrophil index，DNI)与产后出血患者输血需求的关系及临床意义。方法： 连续纳入2019年1月至2023年12月于无锡市妇幼保健院产科经阴道分娩24 h内发生产后出血患者206例，根据是否需要输血分为输血组和非输血组，收集临床资料，包括分娩前24 h内Fib和DNI，行回顾性分析。利用二元Logistic回归分析预测产后输血的独立危险因素，并绘制受试者工作特征(ROC)曲线以计算DNI和Fib预测产后输血需求的曲线下面积(AUC)，采用约登指数法计算最佳截断值。结果： 与非输血组相比，输血组Fib和收缩压、血红蛋白等水平明显降低(P＜0.01)，DNI等明显升高(P＜0.01)。二元Logistic回归显示，Fib(OR：0.215，95%CI：0.102～0.452，P＜0.001)和DNI(OR：1.247，95%CI：1.023～1.520，P＜0.001)是输血需求的独立预测因子。ROC曲线结果显示，Fib和DNI预测输血需求的AUC分别为0.748(95%CI：0.683～0.806，P＜0.001)和0.772(95%CI：0.697～0.829，P＜0.001)，最佳截断值分别为2.56 g/L和3.6%，Fib+DNI联合预测输血需求AUC值为0.941(95%CI：0.900～0.969，P＜0.001)。结论： Fib与DNI联合检测可提高对经阴道分娩产后出血患者输血需求的预测能力。

阿尔茨海默病（Alzheimer′s disease,AD）是常见的神经退行性疾病，现有药物疗效有限。中药单体因多靶点特性展现出治疗潜力，但其应用受限于生物利用度低、靶向性差等问题。纳米载体药物递送系统（nanocarrier drug delivery systems，NDDS）可有效跨越血脑屏障，提升药物稳定性与靶向性。本文综述了NDDS在中药单体递送中的应用进展，重点讨论其在AD治疗中的靶向策略、多机制干预及智能响应释放等方面的研究，并展望其面临的挑战与未来发展方向。

Objective: To develop and validate a nomogram model utilizing CT radiomics features for predicting the efficacy of radiotherapy in esophageal squamous cancer. Methods: A retrospective analysis was conducted for 201 patients diagnosed with esophageal squamous cancer at Xuzhou Cancer Hospital and Xuzhou Mining Group General Hospital between January 2019 and January 2024. The dataset was partitioned into the training set (n=79), the testing set (n=34), and the external validation set (n=88). Radiomics features were extracted from pre-radiotherapy CT images of patients, followed by dimensionality reduction. Univariate and multivariate Logistic regression analyses were employed to identify the significant clinical features of the constructed model. The support vector machine learning algorithm was utilized to construct three predictive models: the clinical model, the radiomics model, and the nomogram model. The nomogram model was visualized using a nomogram. The predictive performance of the constructed model was assessed through external validation. The model′s clinical applicability were measured by dicision curve analysis (DCA). Results: A total of 1 834 CT radiomics features were extracted. Following feature screening and dimensionality reduction, eleven optimal radiomics features were selected for subsequent model construction. The area under curve (AUC) for the nomogram model in the training set was 0980, which exceeded that of both the clinical model (AUC=0.859) and the radiomics model (AUC=0.926). In the testing set, the AUC for the nomogram model was 0.834, surpassing the clinical model (AUC=0.638) and the radiomics model (AUC=0.818). Furthermore, in the external validation set, the AUC for the nomogram model was 0883, outperforming the clinical model (AUC=0.652) and the radiomics model (AUC=0.765). DCA results demonstrated that the nomogram model had the highest clinical net benefit in comparison to the alternative models. Conclusion: The developed nomogram model, which integrates CT radiomics and clinical features, may be applied for predicting the efficacy of radiotherapy for esophageal squamous cancer.

Objective: To explore the mechanism of FK506 binding protein 5 (FKBP5, also known as the FKBP51) in rat H9C2 cardiomyocytes injury induced by oxygen-glucose deprivation/reperfusion (OGD/R). Methods: H9C2 cells were divided into the blank control group, OGD/R group and OGD/R + small interfering RNA silencing FKBP5 (OGD/R+si-FKBP5) group. The contents of lactate dehydrogenase (LDH), creatine kinase isozyme (CK-MB) and cardiac troponin I (cTnI) in each group of H9C2 cells were detected by enzyme-linked immunosorbent assay (ELISA), and metabolites differences and signaling pathways were analyzed by principal component analysis (PCA) and enrichment analysis. Results: ELISA results showed that silencing FKBP5 significantly suppressed the increased levels of LDH, CK-MB, and cTnI (P<0.05 and P<0.001). Metabolomics analysis revealed 49 differential metabolites induced by OGD/R treatment, while silencing of FKBP5 resulted in 53 differential metabolites. Pathway hierarchy analysis indicated that OGD/R-induced differential metabolites were involved in amino acid metabolism, endocrine system, membrane transport, and signal transduction pathways, while these pathways showed significant adaptive changes after silencing FKBP5. KEGG pathway analysis further demonstrated that these differential metabolites were enriched in key signaling pathways such as mTOR, FoxO, and cGMP-PKG. The metabolites of these signaling pathway also showed significant adaptive changes after silencing FKBP5. Conclusion: The results suggest that silencing FKBP5 may alleviate OGD/R-induced myocardial injury by regulating multiple key metabolites and signaling pathways.

Objective: To compare the safety and efficacy of peripheral interventional procedures for non-coronary artery disease with the distal transradial access (dTRA) and transfemoral access (TFA). Methods: A total of 232 patients who underwent dTRA or TFA between April 2022 and April 2024 at Wujin Hospital Affiliated to Jiangsu University, and Changzhou First People′s Hospital Affiliated to Soochow University were retrospectively included. General information, intraoperative and postoperative related indicators of the patients were collected to compare the differences between the two groups. Results: Puncture success rate, access-related complications, contrast agent dose during the procedure, fluoroscopy time, dose-area product and air kerma were similar between the two groups (P>0.05). The technical success rate, postoperative puncture site pain scores, postoperative bed rest time, and postoperative hospital stay in the dTRA group were significantly lower than those in the TFA group (P<0.05). Conversely, the time to puncture, the number of punctures, and the duration of surgery in the dTRA group were significantly higher than those in the TFA group (P<0.05). Conclusion: dTRA has early safety and feasibility for peripheral interventions of non-coronary artery disease, but dTRA is technically more challenging than TFA, resulting in a longer operation time.

Objective: To investigate the risk factors for hematoma formation after ultrasound-guided percutaneous renal biopsy (PRB) in patients with lupus nephritis (LN). Methods: This retrospective study included 112 LN patients who underwent ultrasound-guided PRB at Nanjing Drum Tower Hospital between January 2023 and December 2024. Patients were divided into hematoma group (n=33) and non-hematoma group (n=79) based on ultrasound findings within one week after biopsy. The general characteristics, laboratory data, and postoperative pathological results after PRB were compared between the two groups, and the risk factors for hematoma formation after PRB were analyzed by Logistic regression. Results: Hematomas were observed in 33 patients, including 20 small, 10 medium, and 3 large hematomas. There were statistically significant differences between the two groups in terms of a history of hypertension (P=0.002), chronic kidney disease (CKD) staging > stage 1 (P=0.005), andactivity index (AI) >5.5 (P=0.003). Multivariate Logistic regression analysis confirmed hypertension (OR: 3.110, 95%CI: 1.169-8.279, P=0.023), CKD staging > stage 1 (OR:2.575, 95%CI: 1.043-6.362, P=0.040), and AI>5.5 (OR: 2.737, 95%CI: 1.076-6.691, P=0.034) were independent risk factors for hematoma formation. Conclusion: Hypertension, CKD staging > stage 1, and AI>5.5 may significantly increase the risk of hematoma formation after PRB.

Objective: To investigate the function and potential mechanism of OTU domain-containing ubiquitin aldehyde-binding protein 1 (OTUB1) gene in acetaminophen (APAP) induced acute liver injury (ALI) and its potential mechanism. Methods: The signaling pathways related to ALI induced by APAP were studied by bioinformatics analysis, and the genes co-expressed with ferroptosis were screened out. Various doses (0, 200, 300, 400 mg/kg) of APAP were intraperitoneally injected into BALB/c mice. The contents of enzymes and cytokines, liver coefficient, expression levels of OTUB1 and solute carrier family 7 member 11 （SLC7A11） were detected. HE staining was used to observe the pathological changes of visceral tissues. Finally, OTUB1-overexpressing LO2 and QSG-7701 hepatocyte lines were constructed. The effects of OTUB1 overexpression on APAP-induced liver cell damage were analyzed by detecting cell viability, enzyme and cytokine contents, reactive oxygen species and mitochondrial membrane potential. Results: The results of bioinformatics showed that APAP-induced ALI and acute liver failure intersected with 12 ferroptosis genes, among which the OTUB1 gene, which was significantly downregulated in expression, was included. The results of animal experiments showed that APAP-induced ALI could cause inflammation in mice and down-regulate the expression of OTUB1 and SLC7A11 in a dose-dependent manner. The results of cell experiments showed that LO2 and QSG-7701 hepatocytes with overexpression of OTUB1 attenuate resist cellular inflammation, oxidative stress and mitochondrial damage caused by APAP. Conclusion: The OTUB1 gene may alleviate ALI induced by APAP by activating the SLC7A11 signaling pathway.

细胞自噬和凋亡对维持细胞稳态具有重要作用。低氧状态可诱发缺氧诱导因子-1α（hypoxia induce factor1α，HIF-1α）及其下游靶标Bcl2/腺病毒E1B相互作用蛋白3（BNIP3）表达，HIF-1α/BNIP3信号通路上调，从而促进自噬，减轻或改善细胞损伤；也可通过促进自噬，诱导细胞凋亡。但也存在调控的多样性，如在轻度缺氧情况下，通过增强自噬减轻缺氧/复氧诱导的心肌细胞损伤；而在重度缺氧情况下，则会通过增强自噬引起心肌细胞凋亡。本文梳理了HIF1α/BNIP3信号通路在不同疾病和低氧状态下对细胞自噬的调控机制，为疾病的诊治提供新的思路和切入点。

Objective: To investigate the body composition factors associated with the occurrence of spontaneous vertebral compression fractures (SVCF) in individuals with low bone mass or osteoporosis. Methods: A retrospective analysis was conducted on 144 individuals with low bone mass or osteoporosis who underwent non-contrast chest abdomen CT and received QCT-based bone mineral density measurement and body composition analysis, including 72 cases in the vertebral fractures group and 72 cases in the non-vertebral fracture group. There was no significant differences in age and sex between the two groups. QCT-assessed parameters included bone mineral density (BMD), vertebral cross-sectional area (CSA), paraspinal muscle CSA, total abdominal fat CSA, visceral fat CSA, and paraspinal intramuscular fat CSA. Differences in various indicators between groups were compared. Multivariate logistic regression was used to identify independent risk factors for SVCF. ROC curve analysis and the DeLong test were applied to evaluate diagnostic performance. Partial correlation analysis was used to assess the correlation between variables and the degree of fracture compression. Results: Compared to the non-vertebral fracture group, patients in the vertebral fracture group had significantly increased paraspinal intramuscular fat CSA and fat infiltration, and significantly decreased BMD (P<0.05). Multivariate logistic regression revealed that BMD (OR=0.62, P<0.001) and paraspinal muscle fat infiltration (OR=1.79, P<0.001) were independent risk factors for SVCF. ROC curve analysis showed that the AUCs for diagnosing SVCF using BMD and paraspinal muscle fat infiltration were 0.71 and 0.68, respectively. The combined diagnostic AUC was 0.86. DeLong tests confirmed that the combined model had significantly higher AUC than either factor alone (all P<0.05). Partial correlation analysis showed that BMD was negatively correlated with the degree of fracture compression (r=－0.72, P<0.001), while paraspinal muscle fat infiltration was positively correlated (r=0.61, P<0.001). Conclusion: Decreased BMD and increased paraspinal muscle fat infiltration significantly elevate the risk of SVCF, and their coexistence exerts an even higher risk.