Precancerous lesions of gastric cancer (PLGC) represent a critical stage preceding the development of gastric cancer. Their progression to gastric cancer remains a significant challenge in clinical prevention and treatment. Recent studies have shown that glycolytic reprogramming is a dynamic and modifiable metabolic process in PLGC. It may emerge during the progression of PLGC and contribute to the pathological remodeling of the gastric mucosa. This article reviews the stage-specific characteristics, pathogenesis, and therapeutic potential of glycolytic reprogramming in PLGC. During the progression of PLGC, glycolytic activity may be activated early on, diminish during the glandular atrophy stage, and be reactivated during intestinal metaplasia (IM), dysplasia, and spasmolytic polypeptide-expressing metaplasia (SPEM). Key regulatory factors include Helicobacter pylori (H. pylori) infection, the PI3K/Akt/mTOR-HIF-1α axis, glucose uptake mediated by glucose transporters (GLUTs), microRNAs (miRNAs), the p53/TIGAR pathway, and p57. These metabolic alterations may promote PLGC progression through an imbalance between proliferation and apoptosis, lactate accumulation, and the formation of an acidic microenvironment. Intervention strategies targeting glycolytic reprogramming may offer potential approaches for metabolic intervention in PLGC. These strategies include traditional Chinese medicine formulations, natural bioactive compounds, and glycolysis inhibitors derived from gastric cancer research.

BackgroundHigh-intensity noise is associated with noise-induced hearing loss (NIHL). There is also evidence that noise exposure is related to cognitive impairment. This research aimed to analyze the associations and potential pathways of cumulative noise exposure (CNE), hearing loss and cognitive impairment.MethodsA total of 560 research subjects were included in this research from May 2021 to April 2022 in western China. The demographic features, occupational features, and CNE were investigated and examined. Hearing loss was evaluated according to the National standard GB/T 7583–1987 of China. The Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) were used to assess cognitive function. Structural equation modeling (SEM) was used to analyze the potential pathways and specific effect sizes of CNE, hearing loss and cognitive impairment.ResultsThe mean age of the research subjects was 34.3 (SD, 9.89). Men accounted for 96.4% (540/560) and women accounted for 3.6% (20/560). A total of 62.3% (349/560) held a college degree or above. The regression analysis showed that high dose CNE was related to MMSE (β = −1.069 (−1.539, −0.600)) and MoCA (β = −1.040 (−1.726, −0.355)) scores. The monaural threshold weighted value of the right ear (MTWVR) greater than 40 dB was associated with both MMSE (β = −1.183 (−2.033, −0.333)) and MoCA (β = −1.420 (−2.647, −0.193)) scores. The monaural threshold weighted value of the left ear (MTWVL) greater than 40 dB was also associated with MMSE (β = −1.540 (−2.389, −0.690)) and MoCA (β = −1.685 (−2.915, −0.456)) scores. The SEM result (Model C) showed that the standard effect of CNE- hearing loss path, CNE-MMSE path, and hearing loss-MMSE path were 0.142 (p < 0.001), −0.151 (p < 0.001), and −0.030 (p = 0.376). The Model D showed that the standard effect of CNE- hearing loss path, CNE- MoCA path, and hearing loss- MoCA path were 0.143 (p < 0.001), −0.048 (p = 0.267), and − 0.050 (p = 0.047). The CNE had only a direct effect on the MMSE score. Conversely, the CNE had only an indirect effect on the MoCA score, while hearing loss was borderline associated with MoCA. The total effects of CNE on MMSE and MoCA scores were −0.151 and −0.007, respectively.ConclusionJob-related noise exposure is not only associated with NIHL but also with early cognitive impairment in occupational groups. However, there is not enough evidence indicating that NLHL mediates the associations.

BackgroundNon-alcoholic fatty liver disease (NAFLD) is a highly prevalent liver disease worldwide and lack of research on the diagnostic utility of mitochondrial regulators in NAFLD. Mitochondrial dysfunction plays a pivotal role in the development and progression of NAFLD, especially oxidative stress and acidity β-oxidative overload. Thus, we aimed to identify and validate a panel of mitochondrial gene expression biomarkers for detection of NAFLD.MethodsWe selected the GSE89632 dataset and identified key mitochondrial regulators by intersecting DEGs, WGCNA modules, and MRGs. Classification of NAFLD subtypes based on these key mitochondrial regulatory factors was performed, and the pattern of immune system infiltration in different NAFLD subtypes were also investigated. RF, LASSO, and SVM-RFE were employed to identify possible diagnostic biomarkers from key mitochondrial regulatory factors and the predictive power was demonstrated through ROC curves. Finally, we validated these potential diagnostic biomarkers in human peripheral blood samples and a high-fat diet-induced NAFLD mouse model.ResultsWe identified 25 key regulators of mitochondria and two NAFLD subtypes with different immune infiltration patterns. Four potential diagnostic biomarkers (BCL2L11, NAGS, HDHD3, and RMND1) were screened by three machine learning methods thereby establishing the diagnostic model, which showed favorable predictive power and achieved significant clinical benefit at certain threshold probabilities. Then, through internal and external validation, we identified and confirmed that BCL2L11 was significantly downregulated in NAFLD, while the other three were significantly upregulated.ConclusionThe four MRGs, namely BCL2L11, NAGS, HDHD3, and RMND1, are novel potential biomarkers for diagnosing NAFLD. A diagnostic model constructed using the four MRGs may aid early diagnosis of NAFLD in clinics.

多囊卵巢综合征(polycystic ovary syndrome,PCOS)是一种女性多发的内分泌异常疾病,发病率为6％～10％,其病因尚不清楚[1].PCOS患者在临床上的主要表现为高雄激素血症、卵巢多囊样改变、稀发排卵或无排卵[2],同时伴有多种内分泌及机体代谢异常,包括糖耐量受损、胰岛素抵抗、肥胖等[3].姜黄素是一种多酚类化合物,味微苦,不溶于水[4].有研究报道,姜黄素可改善PCOS患者体内糖代谢异常、减轻胰岛素抵抗(insulin resistance,IR)、抗炎及抗氧化、降低血管内皮生长、改善脂代谢异常症状、减轻体重、改善高雄激素血症、维持健康肠道菌群[5,6].笔者拟就近年姜黄素对PCOS作用机制的研究进展进行综述如下.

Sleep apnea is a common sleep disorder caused by decreased blood oxygen saturation during sleep. Polysomnography is the gold standard for early detection. Because of the complicated operation and high price, it is gradually out of the public view. In recent years, single-lead electrocardiogram (ECG) signal detection sleep apnea methods based on deep learning have significantly progressed. This paper proposes a multi-scale temporal convolutional network (MTCNet) to detect sleep apnea. MTCNet uses multi-scale convolutional networks to capture fine-grained and coarse-grained features. This design enhances the analysis of characteristics associated with sleep apnea. The proposed MTCNet model significantly improved sleep apnea detection compared to previous methods. In our proposed model, the accuracy reached 91.5%, and the average sensitivity and specificity reached 85.8% and 95.0%, respectively.

慢性萎缩性胃炎(CAG)是一种机制复杂、病因多样且患病率较高的胃癌前病变,健脾益气法作为治疗CAG的重要治疗大法,具有提升生活质量、加强常规药物疗效、逆转黏膜病变等优点,对于因先天禀赋不足、外邪侵袭、情志不遂、饮食失节等导致的脾胃气虚型CAG有着明显效果,在临床治疗中被广泛应用.根据现代研究发现,基于此法所用方药具备抑制炎症因子、调控基因、胃液、降低细菌感染、调节细胞增殖凋亡、影响免疫细胞等作用,因而认为健脾益气法治疗CAG作用机制可能与抗炎、修复保护胃黏膜、清除幽门螺杆菌、调控信号通路以及调节机体免疫等有关.现通过总结相关文献,对健脾益气法治疗CAG的机制进行论述.

Background A major shift in the “dynamic zero-COVID” policy was announced by China’s National Health Commission on December 7, 2022, and the subsequent immediate large-scale outbreak of SARS-CoV-2 infections in the entire country has caused worldwide concern. This observational cross-sectional study aimed to describe the epidemiological characteristics of this outbreak in Sichuan, China. Methods All data were self-reported online by volunteers. We described the epidemic by characterizing the infection, symptoms, clinical duration, severity, spatiotemporal clustering, and dynamic features of the disease. Prevalence ratio (PR), Odds ratios (ORs) and adjusted ORs were calculated to analyze the associations between risk factors and infection and the associations of risk factors with clinical severity using log-binomial and multivariable logistic regression models; 95% confidence intervals (CIs) and Wald test results were reported. The prevalence rates and clinical severity among different subgroups were compared using the Chi-square and trend Chi-square tests. Results Between January 6 and 12, 2023, 138,073 volunteers were enrolled in this survey, and 102,645 were infected with COVID-19, holding a prevalence rate of 74.34%; the proportion of asymptomatic infections was 1.58%. Log-binomial regression revealed that the risk of infection increased among those living in urban areas. Multivariable logistic regression analysis showed that female sex, chronic diseases, older age and the fewer doses of vaccine received were associated with an increased risk of severe clinical outcomes after infection. We estimated the mean reproduction number during this pandemic was 1.83. The highest time-dependent reproduction number was 4.15; this number decreased below 1 after 11 days from December 7, 2022. Temporal trends revealed a single peak curve with a plateau pattern of incidence during the outbreak, whereas spatiotemporal clustering analysis showed that the onset in 21 cities in the Sichuan province had four-wave peaks. Conclusions The peak of the first wave of Omicron infection in Sichuan Province had passed and could be considered a snapshot of China under the new control strategy. There were significant increases in the risk of severe clinical outcomes after infection among females, with chronic diseases, and the elderly. The vaccines have been effective in reducing poor clinical outcomes.

ObjectiveThe complicated association of daytime napping, biological aging and cognitive function remains inconclusive. We aimed to evaluate the cross-sectional and longitudinal associations of daytime napping and two aging measures with cognition and to examine whether napping affects cognition through a more advanced state of aging.MethodsData was collected from the China Health and Retirement Longitudinal Study. Napping was self-reported. We calculated two published biological aging measures: Klemera and Doubal biological age (KDM-BA) and physiological dysregulation (PD), which derived information from clinical biomarkers. Cognitive z-scores were calculated at each wave. Linear mixed models were used to explore the longitudinal association between napping, two aging measures, and cognitive decline. Mediation analyses were performed to assess the mediating effects of biological age acceleration on the association between napping and cognition.ResultsParticipants aged over 45 years were included in the analyses. Non-nappers had greater KDM-BA and PD [LS means (LSM) = 0.255, p = 0.007; LSM = 0.085, p = 0.011] and faster cognitive decline (LSM = −0.061, p = 0.005)compared to moderate nappers (30–90 min/nap). KDM-BA (β = −0.007, p = 0.018) and PD (β = −0.034, p < 0.001) showed a negative association with overall cognitive z scores. KDM-BA and PD partially mediated the effect of napping on cognition.ConclusionIn middle-aged and older Chinese, compared to moderate nappers, non-nappers seem to experience a more advanced state of aging and increased rates of cognitive decline. The aging status possibly mediates the association between napping and cognition. Moderate napping shows promise in promoting healthy aging and reducing the burden of cognitive decline in Chinese middle-aged and older adults.

Objective: Curcumin has been used as an adjunct to non-surgical periodontal treatment. However, the efficacy of curcumin in the periodontal therapy remained controversial. This study aimed to evaluate the anti-inflammatory efficacy of curcumin as an adjunct to non-surgical periodontal treatment (NPT) by systematic review. Methods: Databases including Embase, PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), and ClinicalTrials.gov were searched to identify relevant RCTs on the use of curcumin as an adjunct to NPT for the treatment of periodontal disease from inception to July 21, 2021. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. Meta-analysis was then performed using Review Manager 5.3 software. Results: A total of 18 RCTs involving 846 patients/sites were included in this meta-analysis. The results of the meta-analysis revealed that as compared to NPT alone, curcumin as an adjunct to NPT resulted in significant reduction in gingival index (GI) at the 1-week (mean differences (MD) = −0.15, 95% confidence intervals (CI) −0.26 to −0.05, p = 0.005), 2-week (MD = −0.51, 95%CI −0.74 to −0.28, p < 0.0001), 3-week (MD = −0.34, 95%CI −0.66 to −0.02, p = 0.03), 4-week (MD = −0.25, 95%CI −0.48 to −0.02, p = 0.04) or 6-week (MD = −0.33, 95%CI −0.58 to −0.08, p = 0.01) follow-ups. Similar significant reductions were also observed for sulcus bleeding index (SBI) at 1, 2, 4, and 12 weeks. However, there were no statistically significant differences in reducing bleeding on probing (BOP) between curcumin as an adjunct and NPT alone at 4, 12, and 24 weeks. Conclusion: Based on the current evidence, curcumin demonstrates anti-inflammatory efficacies in terms of reducing GI and SBI compared with NPT alone. Moreover, curcumin is a natural herbal medicine with few side effects, and it is a good candidate as an adjunct treatment for periodontal disease.

多囊卵巢综合征(PCOS)是一种复杂的内分泌疾病,可影响女性的生殖、生理状态,若治疗不及时,易出现病情加重或并发症增多等问题.不良的生活习惯会增加育龄期女性的PCOS患病率.近年国内外PCOS诊疗指南均提出将生活方式干预作为PCOS的首选基础治疗,认为其对改善临床症状与控制病情具有重要作用,治疗应当贯穿疾病始终,包括运动习惯、饮食模式、睡眠质量、心理因素等方面.因此,应积极推广生活方式干预与中西医治疗手段相结合,以达到更好的临床治疗效果.

多囊卵巢综合征(PCOS)是妇科常见的生殖内分泌疾病,高雄激素血症是PCOS的核心病理特征.近年来,针灸越来越多的应用于PCOS的降雄治疗,且临床疗效显著,相关的机制研究也在逐渐展开.文章介绍了针灸改善PCOS高雄激素血症的相关机制,并着重总结概述了针刺治疗、针刺联合生活方式调整治疗、针刺联合药物治疗以及灸法治疗的临床研究现状,以期为本病的基础研究及临床实践提供理论依据和参考.

Degenerative dementia, of which Alzheimer's disease is the most common form, is characterized by the gradual deterioration of cognitive function. The events that trigger and promote degenerative dementia are not clear, and treatment options are limited. Experimental and epidemiological studies have revealed chronic noise exposure (CNE) as a potential risk factor for cognitive impairment and degenerative dementia. Experimental studies have indicated that long-term exposure to noise might accelerate cognitive dysfunction, amyloid-β deposition, and tau hyperphosphorylation in different brain regions such as the hippocampus and cortex. Epidemiological studies are increasingly examining the possible association between external noise exposure and dementia. In this review, we sought to construct a comprehensive summary of the relationship between CNE, cognitive dysfunction, and degenerative dementia. We also present the limitations of existing evidence as a guide regarding important prospects for future research.

Treatment of malignant tumors encompasses multidisciplinary comprehensive diagnosis and treatment and reasonable combination and arrangement of multidisciplinary treatment, which is not a simple superimposition of multiple treatment methods, but a comprehensive consideration of the characteristics and specific conditions of the patients and the tumor. The mechanism of tumor elimination by restoring the body’s immune ability is consistent with the concept of “nourishing positive accumulation and eliminating cancer by itself” in traditional Chinese medicine (TCM). The formation and dynamic changes in the tumor microenvironment (TME) involve many different types of cells and multiple signaling pathways. Those changes are similar to the multitarget and bidirectional regulation of immunity by TCM. Discussing the relationship and mutual influence of TCM and antitumor therapy on the TME is a current research hotspot. TCM has been applied in the treatment of more than 70% of cancer patients in China. Data have shown that TCM can significantly enhance the sensitivity to chemotherapeutic drugs, enhance tumor-suppressing effects, and significantly improve cancer-related fatigue, bone marrow suppression, and other adverse reactions. TCM treatments include the application of Chinese medicine monomers, extracts, classic traditional compound prescriptions, listed compound drugs, self-made compound prescriptions, as well as acupuncture and moxibustion. Studies have shown that the TCM functional mechanism related to the positive regulation of cytotoxic T cells, natural killer cells, dendritic cells, and interleukin-12, while negatively regulating of regulatory T cells, tumor-associated macrophages, myeloid-derived suppressive cells, PD-1/PD-L1, and other immune regulatory factors. However, the application of TCM in cancer therapy needs further study and confirmation. This article summarizes the existing research on the molecular mechanism of TCM regulation of the TME and provides a theoretical basis for further screening of the predominant population. Moreover, it predicts the effects of the combination of TCM and antitumor therapy and proposes further developments in clinical practice to optimize the combined strategy.

多囊卵巢综合征(polycystic ovary syndrome,PCOS)是妇科常见的生殖内分泌疾病.发病率在近年全球范围呈持续增长趋势,中医认为影响此病发生涉及的脏腑主要是肝、脾、肾三脏,而这恰恰与现代医学所认识的影响PCOS发病因素,即先天遗传、情感意志、生活方式等有相似之处.在治疗方面,中医多采用中药周期治疗、体质分型治疗和针灸治疗.西医以手术和药物治疗为主.文章是通过大量阅读相关文献和结合临床实践观察从传统中医和现代西医等两个角度对此问题进行归纳总结.

This study aims to evaluate the clinical efficacy of curcumin versus chlorhexidine as adjuncts to scaling and root planing (SRP) for periodontitis treatment. We searched PubMed, EMbase, Cochrane Library, and ClinicalTrials.gov from inception to February 18, 2021 and identified studies with relevant randomized controlled trials (RCTs) using curcumin or chlorhexidine as an adjunct to SRP. Nine RCTs involving 420 patients/sites were included. A meta‐analysis with a random‐effects model revealed that curcumin and chlorhexidine, as an adjunct to SRP, reduced probing pocket depth (PPD) at similar levels during a 3‐, 4‐, 6‐, and 12‐week follow‐up. No significant differences were observed in reducing clinical attachment loss (CAL) between curcumin and chlorhexidine as an adjunct to SRP at 4 weeks and 6 weeks. Furthermore, gingival index (GI) and plaque index (PI) were similar using curcumin versus chlorhexidine as an adjunct to SRP at the 4‐week‐, 6‐week‐, and 12‐week follow‐up. Based on the available evidence in RCTs, compared with chlorhexidine as an adjunct to SRP, curcumin has a similar effect on reducing PPD, CAL, GI, and PI. The quality of evidence is low, limited by the number of studies and their limitations. Further studies are needed to firmly establish the clinical efficacy of curcumin.

This protocol was withdrawn because finishing the project within adequate deadlines could not be achieved.