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.

江苏大学学报（医学版）2025年第1期目次

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。

Lon蛋白酶是一种存在于细胞中的ATP依赖型蛋白酶，主要负责细胞内异常蛋白质的催化分解，以维持生物体内蛋白质的质量水平。Lon广泛参与细胞凋亡、细胞分化和DNA修复等细胞活动。近年来研究发现，哺乳动物细胞中的线粒体Lon(LONP1)异常表达与一系列疾病的发生发展相关，包括线粒体缺陷相关疾病、神经退行性疾病以及癌症等。鉴于LONP1活性的检测与调控对相关疾病的早期诊断和治疗的重要性，本文针对LONP1结构、功能、与相关疾病的关系、活性调控及检测方法作一系统综述。

目的： 观察经尿道输尿管软镜（flexible ureterorenoscopy，F-URS）联合可弯曲负压吸引输尿管导引鞘（简称负压吸引鞘）治疗复杂性肾结石的安全性和有效性。方法： 回顾性分析2021年6月至2023年6月联勤保障部队第906医院收治的456例复杂性肾结石患者的临床资料。根据手术方法不同分为负压组（n=230）和常规组（n=226）。负压组采用经尿道FURS联合负压吸引鞘治疗，常规组采用经尿道FURS钬激光碎石术治疗。比较两组的手术时间、结石清除率、住院时间、围术期并发症等情况。结果： 456例患者均一期完成手术。负压组230例中，200例顺利置入负压吸引鞘并行F-URS钬激光碎石术，5例输尿管扭曲狭窄改行微创经皮肾镜取石术（mini-percutaneous nephrolithotomy，M-PNL），25例输尿管狭窄改行支架管置入术，待后二期FURS。常规组226例中，188例顺利行F-URS，8例输尿管扭曲狭窄改行MPNL，30例输尿管狭窄改行支架管置入术，待后二期FURS。负压组平均手术时间（71.60±15.60）min，明显少于常规组（102.23±2915）min，差异有统计学意义（P<0.01）；负压组结石清除率为82.50%（165/200），明显高于常规组69.15%（130/188），差异有统计学意义（P<0.01）；负压组围术期尿源性感染率为8.50%（17/200），明显低于常规组25.53%（48/188），差异有统计学意义（P<0.05）；两组患者平均住院天数无统计学差异（P＞0.05）。结论： 与常规经尿道FURS钬激光碎石术对比，经尿道F-URS联合负压吸引鞘治疗复杂性肾结石能缩短手术时间，提高结石清除率，减少手术并发症。

宫腔粘连是指子宫内膜损伤后导致宫腔或宫颈部分或全部粘连，可产生继发不孕、闭经和周期性下腹痛等症状。宫腔粘连的临床治疗首选宫腔镜下宫腔粘连分离术联合术后辅助治疗，但术后宫腔再次粘连的发生率较高，严重影响女性的生殖潜力。目前，临床上应用于宫腔粘连术后的辅助治疗手段众多，但尚未明确其最佳诊疗方案。仿生物电刺激联合超声针灸是一种新型的物理治疗方式，具有无痛无创、安全、可操作性强等优点，目前已广泛用于治疗盆底功能障碍性疾病。近来，研究发现仿生物电刺激联合超声针灸在治疗宫腔粘连方面有显著疗效，本文对此作一综述。

Objective： To investigate the clinical efficacy of metformin combined with orlistat in obese patients with polycystic ovary syndrome (PCOS) and insulin resistance. Methods： A total of 150 obese PCOS patients with insulin resistance were randomly divided into control group and research group, with 75 cases in each group. The control group was given basic treatment such as metformin and ethinylestradiol cycloproterone, and the research group was treated with basic treatment combined with orlistat. After 3 months of treatment, the differences in anthropometric indicators, glycolipid metabolism indicators and sex hormone levels between the two groups were compared. Results： After 3 months of treatment, compared with the control group, the body weight, body mass index (BMI), waist-to-hip ratio (WHR), body fat percentage, fasting plasma glucose (FPG), 2 h postprandial plasma glucose (2hPG), fasting insulin (FINS), glycosylated hemoglobin (HbA1c), and homeostasis model assessment-IR (HOMA-IR) of the research group were significantly decreased (P<0.05); and the triglyceride, total cholesterol, low density lipoprotein cholesterol in the research group were also significantly decreased (P<0.05), while high density lipoprotein cholesterol was significantly increased (P<0.05); the levels of luteinizing hormone (LH), estradiol, testosterone, prolactin and LH/follicle stimulating hormone （FSH） were greatly decreased (P<0.05), while there was no significant difference in FSH (P>0.05). Conclusion： Metformin combined with orlistat in the treatment of obese PCOS with insulin resistance could significantly improve the glucose and lipid metabolism, reduce weight and insulin resistance and improve sexual hormone disorder.

脓毒症是可导致机体严重器官功能障碍、危及生命的炎性综合反应，一般是由病原微生物侵入机体引发，近年来发生率和病死率居高不下，是重症监护病房患者死亡的重要原因。细胞焦亡是新发现的一种伴随炎症因子释放的细胞程序性死亡，可一定程度上抵御微生物的感染，但过度激活会诱导和加重脓毒症。目前有研究证明，细胞焦亡的许多相关分子都参与了脓毒症的发病进程，并在其中发挥重要作用。对脓毒症中细胞焦亡的研究不仅可深入阐明细胞焦亡的病理作用和机制，也有助于对脓毒症的发生发展和转归预判，尤其为发现治疗脓毒症的靶点拓展新思路。