IntroductionJingfang Granules (JFG), a classical traditional Chinese medicine formula comprising 11 botanical drugs, have traditionally been prescribed to dispel cold and eliminate dampness. This study aimed to clinically evaluate the efficacy and safety of JFG in accelerating alcohol clearance and mitigating hangover symptoms.MethodsA randomized, double-blind, two-period crossover trial enrolled 48 healthy adults. Participants received JFG (6 sachets × 15 g) or placebo 30 min before consuming 100 mL of 56% ABV baijiu within 10 min. Primary endpoints were plasma alcohol concentrations measured up to 24 h post-consumption. Secondary endpoints included plasma alcohol AUC0–24 h, plasma alcohol dehydrogenase (ADH) and acetaldehyde dehydrogenase (ALDH) activities, hangover severity assessed using the Acute Hangover Scale (AHS), urine output, and safety.ResultsJFG significantly reduced plasma alcohol concentrations from 30 min to 8 h after consumption (P < 0.005) and decreased plasma alcohol AUC0–24 h (P < 0.001) compared with placebo. AHS scores were numerically lower following JFG treatment; however, the differences were not statistically significant (P > 0.05). JFG administration was associated with greater urine volume (P < 0.001) and fewer urination episodes (P = 0.032). No severe or serious adverse events were reported.DiscussionJFG significantly reduced plasma alcohol levels for up to 8 h after consumption and showed a trend toward lower hangover symptom scores; however, the mechanism remains unknown.Clinical Trial Registrationhttps://www.chictr.org.cn/, identifier ChiCTR2400084155.

BACKGROUND & AIMS:The overlap between chronic hepatitis B (CHB) and metabolic dysfunction-associated steatotic liver disease (MASLD) has been growing. This study aimed to explore the impact of CHB and its clinical phases on liver fibrosis/cirrhosis in patients with MASLD. METHODS:We enrolled patients with MASLD who underwent vibration-controlled transient elastography (VCTE) or liver biopsy at 19 centers in China between 2004 and 2025. Logistic regression analyses were conducted to examine the association between CHB and liver fibrosis/cirrhosis. Propensity score matching was used to adjust for potential confounders. RESULTS:A total of 6682 patients with MASLD were included, comprising 3979 VCTE-based cases (351 with concurrent CHB) and 2703 biopsy-proven cases (1811 with concurrent CHB). In the VCTE cohort, patients with MASLD and CHB had higher proportions of significant fibrosis (50.1% vs 33.5%), advanced fibrosis (25.4% vs 10.8%), and cirrhosis (15.7% vs 5.4%) (all P < .001), with similar findings in the biopsy cohort. Multivariate analyses showed that concurrent CHB independently increased the risks of fibrosis/cirrhosis in both cohorts (odds ratios [ORs]: VCTE cohort: 1.98-3.73; biopsy cohort: 1.98-3.37; all P < .001). Under the 2018 American Association for the Study of Liver Diseases criteria, hepatitis B e-antigen-positive immune-active CHB had the highest odds of significant fibrosis, advanced fibrosis, and cirrhosis (OR, 3.27-11.18; P ≤ .001), with elevated odds also observed in gray-zone CHB (OR, 3.05-6.95; P ≤ .001); associations remained similar after propensity score matching and application of the 2025 European Association for the Study of the Liver classification. CONCLUSIONS:Concurrent CHB increased liver fibrosis/cirrhosis risk in MASLD not only in the immune-active phase but also in the gray-zone phase. Patients with MASLD and concomitant active/gray-zone CHB may warrant enhanced noninvasive monitoring and individualized management to mitigate fibrotic progression.

RATIONALE AND OBJECTIVES:MRI-proton density fat fraction (MRI-PDFF) is widely applied in clinical practice for hepatic fat quantification. However, the conventional manual region of interest (ROI) method is time-consuming and operator-dependent, and the diagnostic accuracy of artificial intelligence (AI)-based models for hepatic steatosis assessment remains to be fully clarified. This study aimed to evaluate the diagnostic performance of an AI-based whole liver segmentation (WLS) model for histological hepatic steatosis grading, and to technically validate its segmentation performance and agreement with manual ROI-based PDFF measurement. MATERIALS AND METHODS:A total of 538 adults who underwent MRI-PDFF examinations were enrolled. A VBB-Net segmentation model was developed in a training cohort of 372 patients (418 examinations). Validation was performed in a consecutive cohort of 166 adults who underwent liver biopsy for suspected metabolic dysfunction-associated steatotic liver disease (MASLD). Histological steatosis grading (S0-S3) was used as the reference standard. RESULTS:The mean Dice coefficients were 0.94 ± 0.05 in the training cohort and 0.93 ± 0.04 in the validation cohort. Margins of error were 0.794% for AI-WLS-PDFF and 0.821% for ROI-PDFF. The AUROCs (95% CI) of AI-WLS-PDFF for diagnosing S0-S3 were 0.995 (95% CI: 0.989, 1.000), 0.951 (95% CI: 0.921, 0.980), and 0.928 (95% CI: 0.888, 0.968), respectively. AI-WLS-PDFF showed excellent agreement with ROI-PDFF (ICC, 0.996; 95% CI: 0.995, 0.997) with minimal bias (mean difference, -0.06%; 95% agreement limits: -1.59% to 1.47%). CONCLUSION:The AI-WLS-PDFF model showed high diagnostic performance for histological steatosis grading and excellent agreement with manual ROI-PDFF, supporting its potential as an automated approach for whole-liver PDFF quantification in patients with MASLD. The proposed cutoff values should be considered exploratory and require further validation.

Sepsis is systemic inflammation with high mortality, accompanied by multi-organ failure including acute respiratory distress syndrome. Extracellular vesicles (EVs) encapsulating bioactive cargoes, mediate cell-cell communication to exert systemic regulation. However, whether and how host lung tissue responds quickly to plasma bacterial infection through EVs in sepsis is poorly understood. Here, we identify that peripheral blood macrophages secrete more exosomal G6PD protein to induce lung injury by rewiring purine metabolism during sepsis. Guanine accumulation reduces H3K27 trimethylation and subsequently induces Nos2, Ccl6 and Il6 expression by suppressing de novo EZH2 synthesis. Macrophage-specific Rab27a or G6pd knockout mice had low exosomal G6PD protein in serum, and failed to exert lung injury upon bacterial infection. Beyond, targeting macrophage-derived G6PD by G6PD inhibitors or engineered EVs delivering si-G6pd relieves lung injury in septic mice. In summary, our findings reveal that circulating G6PD promotes lung injury by rewiring purine metabolism and remodeling the epigenetic profile in sepsis, shedding light on the critical role of EVs as a pro-inflammatory signal and targeting G6PD for future sepsis diagnosis and treatment.

[This corrects the article DOI: 10.3389/fphar.2020.01073.].

BACKGROUND AND AIMS:Inflammatory bowel disease (IBD) diagnosis and disease evaluation require endoscopy, histology, or radiology, which are often invasive or expensive. A non-invasive diagnostic method is urgently needed. The present study examined the utility of volatile organic compounds (VOCs) to distinguish IBD from normal controls and monitor disease progression. METHODS:Breath samples were collected from 98 IBD patients, 77 non-IBD controls, and 8 non-IBD enteritis. VOCs were extracted using the solid phase microextraction (SPME) technique and detected using high-resolution gas chromatography-mass spectrometry (GC-MS). Four machine learning models were used in our study. Feature VOCs were those differentially presented in all these four models for diagnosis when compared patients with IBD and non-IBD controls. The performance of the VOC panels in the best selected model was carried out in a training set and confirmed in a validation set and testing set. RESULTS:A total of seven VOCs were selected for the diagnosis of IBD. The Random Forest model showed distinct differentiation between IBD patients and the non-IBD controls in the training set (AUC: 1.000 [1.000, 1.000]), validation set (AUC: 0.978 [0.978, 0.978]) and testing set (AUC: 0.966 [0.906, 1.000]). Among them, four VOCs were found to be related to IBD activity. CONCLUSIONS:Breath VOCs appeared to be useful tools for the diagnosis and activity monitoring of IBD patients.

The coexistence of sarcopenia and obesity has been established as a pivotal factor driving the pathological progression of metabolic dysfunction-associated steatotic liver disease (MASLD). This study systematically evaluates the prevalence and risk of MASLD in patients with sarcopenic obesity (SO). A comprehensive literature search was conducted in PubMed, Cochrane Library, EMBASE, Web of Science and SCOPUS up to March 2025. All studies investigating the association between SO and MASLD were included in this meta-analysis. Two independent reviewers performed screening and data extraction. ORs and 95

BACKGROUND AND AIM:Discriminating between idiosyncratic drug-induced liver injury (DILI) and autoimmune hepatitis (AIH) is critical yet challenging. We aim to develop and validate a machine learning (ML)-based model to aid in this differentiation. METHODS:This multicenter cohort study utilised a development set from Beijing Friendship Hospital, with retrospective and prospective validation sets from 10 tertiary hospitals across various regions of China spanning January 2009 to May 2023. Different ML algorithms were tested using 24 routine laboratory parameters. The Shapley Additive exPlanations (SHAP) analysis was used to evaluate the contribution of each parameter in the ML model. RESULTS:A total of 2554 patients (1750 for DILI and 804 for AIH) were included. Using Gradient Boost Decision Tree algorithm, five key parameters-aspartate transaminase, globulin, prealbumin, creatinine and platelet count-were selected to construct the ML model. Consequently, a web-based tool named Beijing-AID (BJ-AID) was developed (http://43.143.153.225:5000/). The BJ-AID model demonstrated excellent discrimination performance, with an area under the receiver operating characteristic curve (AUROC) of 0.94 (95% CI, 0.902-0.975) in the development set, 0.91 (95% CI, 0.900-0.928) in all external validation sets and 0.93 (95% CI, 0.889-0.974) in a prospective validation set. Notably, the BJ-AID model also effectively discriminated atypical cases, including drug-induced autoimmune-like hepatitis and AIH with the history of drug consumption, achieving an AUROC = 0.85 (95% CI, 0.742-0.949). CONCLUSIONS:We successfully developed and validated a machine learning-based model, BJ-AID, which exhibits a strong discrimination performance. BJ-AID can assist practitioners and hepatologists in diagnosing both typical and atypical cases of DILI and AIH. TRIAL REGISTRATION:ClinicalTrials.gov identifier: NCT05532345.

Postoperative agitation or postoperative delirium (EA/ED) has a high incidence among pediatric patients undergoing anesthesia and surgery. In this study, we aimed to evaluate the effects of sacral anesthesia with 0.125 mL/kg of 1% lidocaine on EA/ED in children undergoing hidden penis and hypospadias surgery. Sixty preschool children undergoing elective hidden penis or hypospadias surgery were enrolled in the study. The postoperative EA/ED score and incidence; Face, Legs, Activity, Cry, and Consolability scale; perioperative general information and vital signs; and the occurrence of adverse events were analyzed. Ultrasound-guided sacral anesthesia in children resulted in more stable vital signs, postoperative pain relief, fewer complications, and lower incidence of EA/ED. In conclusion, the use of 0.125 mL/kg of 1% lidocaine combined with laryngeal mask general anesthesia significantly reduced the incidence of EA/ED in children undergoing hidden penis and hypospadias surgery while ensuring high perioperative safety. ### Competing Interest Statement The authors have declared no competing interest. ### Clinical Trial ChiCTR2200061552 ### Funding Statement Medical Education Research Project of Henan Province (WJLX2024007); Henan Province Medical Science and Technology Research Program Project (LHGJ20220068). ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Ethics Committee of Henan Provincial People's Hospital (No. 11,2022) I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes The raw data supporting the conclusions of this article will be made available by the authors on request

Background:Sarcopenia, physical activity (PA), and sedentary behavior are associated with metabolic dysfunction-associated steatotic liver disease (MASLD). The study aimed to evaluate the effects of sarcopenia and PA on the presence and severity of MASLD. Methods:This cross-sectional study analyzed data from the 2017-2018 National Health and Nutrition Examination Survey (NHANES). Hepatic steatosis and liver fibrosis were assessed by vibration-controlled transient elastography (VCTE). Sarcopenia was defined based on the Foundation for the National Institutes of Health criteria. PA and sedentary behavior were evaluated using the Global Physical Activity Questionnaire (GPAQ). Results:Among 1,831 participants, 664 were diagnosed with MASLD, including 482 with severe steatosis and 89 with significant fibrosis. The prevalence of sarcopenia in the MASLD and non-MASLD populations was 11.7% and 3.8%, respectively. Multivariable-adjusted models demonstrated that sarcopenia significantly increased the risk of MASLD (OR 2.45; 95% CI: 1.33-4.52), severe steatosis (OR 2.56; 95% CI: 1.40-4.66), and significant fibrosis (OR 6.10; 95% CI: 2.08-17.84). Additionally, individuals with sarcopenia and low PA had a 7.91-fold increased risk of developing significant fibrosis (OR, 7.91; 95% CI: 1.42-44.16, P = 0.022). Sarcopenia and prolonged sedentary behavior further increased the risk of MASLD (OR 3.75; 95% CI: 1.60-8.76), severe steatosis (OR 17.58; 95% CI: 1.93-159.79), and significant fibrosis (OR 4.32; 95% CI: 1.31-14.31). Conclusion:Patients with sarcopenia should increase physical activity and reduce sedentary time to decrease the risk and progression of MASLD. Increasing muscle mass and strength through resistance exercise to reduce the risk of significant fibrosis in sarcopenia patients.

ObjectivesTo explore the correlation between serum Golgi protein 73 (GP73) levels and the degree of fibrosis in Metabolic dysfunction associated steatotic liver disease (MASLD); to establish a non-invasive diagnostic algorithm based on serum GP73 and liver elasticity.MethodsThis is a prospective cross-sectional study, including 228 patients diagnosed with MASLD from May 2018 to January 2024 at two tertiary hospitals. Clinical data and hepatic pathological features and the correlation between serum GP73 and liver fibrosis were assessed. A new algorithm was conducted after logistic regression. Receiver Operating Characteristic (ROC) curve was used to compare its diagnostic performance with traditional models.ResultsSignificant fibrosis was diagnosed in 37.2% (85/228) patients. Serum GP73 levels were markedly higher in patients with significant fibrosis than in those without (128 ng/mL v.s 46 ng/mL, p< 0.001). Serum GP73 levels independently predicted significant liver fibrosis (adjusted odds ratio, aOR 1.028, p< 0.001). A new algorithm based on GP73 was developed with a higher area under ROC (AUC) of 0.840 than that of Fibrosis index-4 (p< 0.001).ConclusionsSerum GP73 is an independent risk factor for significant liver fibrosis in MASLD, and the GFA (GP73-Fibroscan-Age) model has good diagnostic efficacy for significant liver fibrosis.

Background: It is crucial to evaluate liver fibrosis in metabolic dysfunction-associated steatotic liver disease (MASLD). Digital pathology, an automated method for quantitative fibrosis measurement, provides valuable support to pathologists by providing refined continuous metrics and addressing inter-observer variability. Although non-invasive tests (NITs) have been validated as consistent with manual pathology, the relationship between digital pathology and NITs remains unexplored. Methods: This study included 99 biopsy-proven MASLD patients. Quantitative-fibrosis (Q-Fibrosis) used second-harmonic generation/two-photon excitation fluorescence microscopy (SHG/TPEF) to quantify fibrosis parameters (q-FPs). Correlations between eight NITs and q-FPs were analyzed. Results: Using manual pathology as standard, Q-Fibrosis exhibited excellent diagnostic performance in fibrosis stages assessment with area under the receiver operating characteristic curves (AUCs) ranging from 0.924 to 0.967. In addition, magnetic resonance elastography (MRE) achieved the highest diagnostic accuracy (AUC: 0.781–0.977) among the eight NITs. Furthermore, MRE-assessed liver stiffness measurement (MRE-LSM) showed the strongest correlation with q-FPs, particularly adjusted by string length, string width, and the number of short and thick strings within the portal region. Conclusions: Both MRE and digital pathology demonstrated excellent diagnostic accuracy. MRE-LSM was primarily determined by collagen extent, location and pattern, which provide a new perspective for understanding the relationship between the change in MRE and histological fibrosis reverse.

There are high rates of human immunodeficiency virus (HIV) and Treponema pallidum coinfection, HIV can increase the incidence and disability rate of neurosyphilis. However, there is a lack of data about the risk factors associated with the development of symptomatic neurosyphilis (SNS). We retrospectively reviewed the medical records of inpatients with concurrent syphilis and HIV infection who underwent a lumbar puncture and completed cerebrospinal fluid (CSF) examination. Sixty inpatients were consecutively enrolled from Beijing Ditan Hospital between January 2015 and March 2023. The clinical and laboratory features were evaluated between the SNS and asymptomatic neurosyphilis (ANS) groups. All patients were male, 25% (15/60) patients were diagnosed with ANS, and 75% (45/60) patients were diagnosed with SNS. Meningovascular neurosyphilis was the most prevalent clinical form in this study. Age, CD4 cell count, highly active antiretroviral therapy use, and serum HIV viral load showed no statistically significant differences between the 2 groups. The SNS group lacked early detection of syphilis (P < .001) and did not get previous adequate therapy for syphilis (P < .001) than the ANS group, as well as a higher initial serum toluidine red unheated serum test (TRUST) titer, current serum TRUST titer, CSF white blood cell count (WBC), protein concentration, and CSF TRUST titer (P = .014, P = .042, P = .01, P = .007, and P = .007, respectively). In multivariable logistic regression, high CSF WBC count (odds ratio = 1.08; P = .032) and previous treatment of syphilis (odds ratio = 0.01; P = .049) related to the SNS. Lack of antisyphilis treatment in the early stage of syphilis and a higher CSF WBC count are related risk factors for SNS in HIV-infected patients. Meningovascular neurosyphilis should get more attention in young patients with cryptogenic stroke.

BACKGROUND:Magnetic resonance elastography (MRE) is recognized as the most precise imaging technology for assessing liver fibrosis in individuals with metabolic dysfunction-associated steatotic liver disease (MASLD). We aimed to investigate the clinical factors and pathological characteristics that may impact LSM in MASLD patients. METHODS:This cross-sectional study recruited 124 patients who concurrently performed MRE, MRI-PDFF, and biopsy-proven MASLD. Linear regression models, Spearman's correlation, and subgroup analysis were employed to identify the variables affecting LSM. RESULTS:The AUROC (95 % CI) of MRE for diagnosing fibrosis stage ≥ 1, 2, 3, and 4 was 0.80 (0.70-0.90), 0.76 (0.66-0.85), 0.92 (0.86-0.99), and 0.99 (0.99-1.00), with corresponding cutoffs of 2.56, 2.88, 3.35, and 4.76 kPa, respectively. Multivariate analyses revealed that AST was the only independent clinical variable significantly correlated with LSM. Furthermore, LSM exhibited a notable association with the grade of lobular inflammation and hepatocellular ballooning. Subgroup analysis showed that when AST ≥ 2 ULN or inflammation grade ≥ 2, LSM of patients with early fibrosis stages showed a slight but significant increase. CONCLUSION:MRE demonstrates significant diagnostic accuracy in predicting liver fibrosis stages for MASLD patients, especially for advanced liver fibrosis and cirrhosis. However, elevated AST and the severity of liver inflammation may impact its accuracy in staging early liver fibrosis.

Research advances over the past 30 years have confirmed a critical role for genetics in the etiology of dilated cardiomyopathies (DCMs). However, full knowledge of the genetic architecture of DCM remains incomplete. We identified candidate DCM causal gene, C10orf71, in a large family with 8 patients with DCM by whole-exome sequencing. Four loss -offunction variants of C10orf71 were subsequently identified in an additional group of492 patients with sporadic DCM from 2 independent cohorts. C10orf71 was found to be an intrinsically disordered protein specifically expressed in cardiomyocytes. C10orf71 -KO mice had abnormal heart morphogenesis during embryonic development and cardiac dysfunction as adults with altered expression and splicing of contractile cardiac genes. C10orf71 -null cardiomyocytes exhibited impaired contractile function with unaffected sarcomere structure. Cardiomyocytes and heart organoids derived from human induced pluripotent stem cells with C10orf71 frameshift variants also had contractile defects with normal electrophysiological activity. A rescue study using a cardiac myosin activator, omecamtiv mecarbil, restored contractile function in C10orf71 -KO mice. These data support C10orf71 as a causal gene for DCM by contributing to the contractile function of cardiomyocytes. Mutation -specific pathophysiology may suggest therapeutic targets and more individualized therapy.

INTRODUCTION AND OBJECTIVES:Significant fibrosis is an indicator of clinical intervention for both chronic hepatitis B (CHB) and metabolic dysfunction-associated steatotic liver disease (MASLD). There remains a paucity of data regarding the clinical impact of biopsy-defined MASLD on significant fibrosis in CHB patients. The current study aims to elucidate whether patients with concomitant MASLD are at higher risk of significant fibrosis in patients with CHB. PATIENTS AND METHODS:This retrospective research of two tertiary hospitals comprised 1818 patients between 2009 and 2021 with CHB and hepatic steatosis who had not received antiviral therapy. Pathologic findings by liver biopsy were contrasted between CHB group (n = 844) and CHB + MASLD (n = 974) group. METAVIR values of F≥2 were used to categorize significant fibrosis. RESULTS:Patients with CHB + MASLD had more significant fibrosis (35.5 % vs. 23.5 %, p < 0.001) than CHB group. The presence of MASLD [adjusted odds ratio (aOR) 2.055, 95 % confidence interval (CI) 1.635-2.584; p < 0.001] was strongly associated with significant fibrosis in all CHB patients. There was a trend for patients with more cardiometabolic risk factors (CMRFs) to have a higher prevalence of significant fibrosis: (25.7 % in CMRF1 subgroup v.s. 34.9 % in CMRF2 subgroup v.s. 53.7 % in CMRF≥ 3 subgroup, p < 0.001). Patients with CMRF≥3 had a three-fold higher significant fibrosis than those with just one CMRF. CONCLUSIONS:MASLD was associated with higher fibrosis stage in patients with CHB. Early detection and intervention are crucial to patients with three or more cardiometabolic risk factors.

BACKGROUND AND AIM:Several studies have identified that three SAMM50 polymorphisms (rs2073082, rs738491, rs3761472) are associated with an increased risk of non-alcoholic fatty liver disease (NAFLD). However, the clinical significance of the SAMM50 SNP in relation to NAFLD remains largely unknown. Therefore, we conducted a clinical study and SNP-SNP interaction analysis to further elucidate the effect of the SAMM50 SNP on the progression of NAFLD in the elderly. METHODS:A total of 1053 patients over the age of 65 years were recruited. Liver fat and fibrosis were detected by abdominal ultrasound or FibroScan, respectively. Genomic DNA was extracted and then genotyped by Fluidigm 96.96 Dynamic Array. Multivariable logistic regression was used to evaluate the association between NAFLD and SNP. SNP-SNP interactions were analyzed using generalized multivariate dimensionality reduction (GMDR). RESULTS:The risk of NAFLD was substantially higher in people who carried SAMM50-rs2073082 G and -rs738491 T alleles (OR, 1.962; 95% CI, 1.448-2.659; p < 0.001; OR, 1.532; 95% CI, 1.246-1.884; p = 0.021, respectively) compared to noncarriers. Carriers of the rs738491 T and rs3761472 G alleles in the cohort showed a significant increase in liver stiffness measurements (LSM). The combination of the three SNPs showed the highest predictive power for NAFLD. The rs2073082 G allele, rs738491 T allele and rs3761472 G carriers had a two-fold higher risk of NAFLD compared to noncarriers. CONCLUSIONS:Our research has demonstrated a strong correlation between the genetic polymorphism of SAMM50 and NAFLD in the elderly, which will contribute to a better understanding of the impact of age and genetics on this condition. Additionally, this study provides a potential predictive model for the early clinical warning of NAFLD.

Objective:To explore the influencing factors of efficacy of glucocorticoids in the treatment of moderate to severe ulcerative colitis (UC) in children.Methods:A retrospective case-control study was conducted. The clinical data of 38 children with moderate to severe UC treated with glucocorticoids in Beijing Children's Hospital of Capital Medical University from January 2016 to December 2021 were analyzed. According to the response to glucocorticoids therapy, the patients were divided into steroid-intractable group and steroid-effective group. Kaplan-Meier method was used to calculate the cumulative recurrence rate. Univariate analysis was performed to analyze the differences of clinical data between the two groups, and Logistic regression was used to analyze the risk factors of steroid-intractable UC in children.Results:A total of 38 children with moderate to severe UC were enrolled, including 22 males and 16 females. The median onset age was 10.7 (8.5, 12.7) years old, and the median disease duration was 4.3 (1.1, 13.6) months. The cumulative recurrence rates of 38 UC patients at 3 months, 6 months, 1 year and 2 years after glucocorticoids treatment were 26.3%, 52.6%, 63.7% and 69.5%, respectively. There were 17 patients (44.7%) in steroid-effective group. There were 21 patients (55.3%) in steroid-intractable group, including 16 (42.1%) of steroid dependence and 5 (13.2%) of steroid resistance. In the steroid-intractable group, the PUCAI scores at baseline, on the 3rd day and 5th day of glucocorticoids treatment [65.0 (50.0, 70.0) points vs. 50.0 (37.5, 60.0) points, 25.0 (10.0, 37.5) points vs. 10.0 (10.0, 20.0) points, 25.0 (10.0, 37.5) points vs. 10.0 (5.0, 12.5) points] and early recurrence rate (85.7% vs. 35.3%) were higher than those in steroid-effective group, the recurrence time [4.0 (2.0, 5.0) months vs. 19.0 (7.5, 46.5) months] was shorter than that in steroid-effective group, albumin level at baseline [ (33.3 ± 5.5) g/L vs. (37.6 ± 5.9) g/L] was lower than that in steroid-effective group, and the differences were statistically significant (all P<0.05) . Multivariate Logistic regression analysis showed that the PUCAI score at baseline was an independent risk factor for steroid-intractable UC ( OR = 1.070, 95% CI: 1.011-1.132, P = 0.020) . Conclusions:The rates of steroid dependence and the steroid resistance are high in moderate to severe UC children. Children in the steroid-intractable group have an earlier recurrence time, a higher rate of early recurrence, and a lower albumin level at baseline. The steroid dependence and resistance are more likely to occur in children with moderate to severe UC when PUCAI score at baseline is high.

目的 探讨非酒精性脂肪性肝病(NAFLD)患者心肺适能水平与肝脏脂肪含量、炎症和肝纤维化的关系.方法 入组62例NAFLD患者.采用最大摄氧量(maximal oxygen uptake,VO2 max)来反映心肺适能,以受控衰减参数(controlled attenuated parameter,CAP)反映肝脏脂肪含量,同时检测生化学与人体成分等指标.按照年龄性别判断心肺适能等级,并分析VO2 max与各项指标的相关性.结果 本研究中男性占40例(64.5％),VO2 max、体质量、CAP、ALT、尿酸、体脂率等均显著高于女性(P均<0.05).VO2 max分级为优秀/良好、一般/差和极差的人数,在男性NAFLD组分别为3例、14例和23例,女性分别为10例、11例和1例,两组存在显著性差异(P<0.001).在男性患者中,轻中度和重度脂肪肝患者分别为10例和30例,重度脂肪肝患者BMI[(30.0±3.5)比(25.6±3.0)kg/m2]、肝脏CAP值[(357.2±24.1)比(282.3±15.6)dB/m]、腰臀比[(0.98±0.03)比(0.93±0.03)]、体脂率[(29.7±4.3)比(23.9±4.2)％]等更高,而VO2 max[(30.1±3.2)比(32.8±3.0)mL/(kg·min)]显著低于轻、中度肝脏脂肪变患者(P均<0.05).相关性分析表明,男性NAFLD患者VO2 max与肝脏CAP值、体脂率、内脏脂肪含量、内脏脂肪面积及BMI呈负相关,与四肢骨骼肌指数呈正相关(P均<0.05).结论 VO2 max与肝脏脂肪变的严重程度密切相关.重度脂肪肝患者心肺功能和有氧运动能力低下,尤其男性脂肪肝患者更差.提示男性NAFLD患者运动干预应答不佳,临床治疗时需要根据耐受性制定个体化运动方案.