BACKGROUND Although gastroscopy is a commonly used diagnostic and therapeutic technique,postoperative gastrointestinal dysfunction is prone to occur.Traditional Chinese medicine theory suggests that postoperative gast...BACKGROUND Although gastroscopy is a commonly used diagnostic and therapeutic technique,postoperative gastrointestinal dysfunction is prone to occur.Traditional Chinese medicine theory suggests that postoperative gastrointestinal disorders are related to spleen and stomach weakness.This study hypothesizes that the combination of acupoint application at the Ziwu Liuzhu acupoint and percutaneous acupoint electrical stimulation can promote postoperative gastrointestinal function recovery and alleviate stress reactions.AIM To investigate the effects of acupoint application of Ziwu Liuzhu combined with percutaneous acupoint electrical stimulation on postoperative gastrointestinal function recovery and stress response in patients undergoing gastrointestinal endoscopy surgery.METHODS A total of 120 patients who underwent gastroscopy surgery were selected and treated between October 2024 and January 2025.This study used a stratified block randomization method,and then allocated groups using computer-generated random number sequences(SAS 9.4 software).The groups were divided into two groups:A control group of 60 patients who received routine postoperative intervention measures,and an observation group of 60 patients who received acupuncture point application combined with transcutaneous acupoint electrical CONCLUSION The combination of percutaneous acupoint electrical stimulation in gastroscopy patients has been demonstrated to be both highly safe and effective.The benefits of this approach include the promotion of postoperative gastrointestinal function,the reduction of stress response,the attainment of optimal results,and the enhancement of patient satisfaction.展开更多
BACKGROUND Peripherally inserted central catheter(PICC)is the preferred intravenous route for chemotherapy in patients with cancer,but its complications,especially deep vein thrombosis(DVT),are becoming increasingly p...BACKGROUND Peripherally inserted central catheter(PICC)is the preferred intravenous route for chemotherapy in patients with cancer,but its complications,especially deep vein thrombosis(DVT),are becoming increasingly prevalent.Medical staff proficient in intubation and maintenance techniques can reduce complications.The multivariate integration teaching model applies the integration of“teaching learning application”to medical training,which helps shift the prevention of complications from“passive management of complications”to“active construction of risk immunity”,thereby ensuring foundational competency for PICC in patients with cancer.AIM To investigate the efficacy of the multivariate integration teaching model in patients with gastric cancer and concurrent DVT after PICC intubation and analyze its effect on patients’quality of life index(QLI)and satisfaction.METHODS A retrospective analysis of medical records of 100 patients with gastric cancer and PICC treated at Zhejiang Provincial People’s Hospital from May 2019 to November 2020 was conducted.According to the different treatment methods and teaching modes received by medical staff,they were divided into a control group and an experimental group,with 50 cases in each group.The routine clinical teaching model and the multivariate integration teaching model were administered to the medical staff for the control group and the experimental group,respectively,to compare the incidence rates of DVT and other adverse reactions,QLI scores,Karnofsky Performance Scale scores,Mental Status Scale in Non-Psychiatric Settings scores,patient satisfaction,medical staff’s test marks,and satisfaction evaluation of the teaching model.RESULTS Compared with the control group,the experimental group exhibited significantly lower incidence rates of DVT and other adverse reactions and MSSNS scores but significantly higher QLI scores,KPS scores,patient satisfaction,medical staff’s test marks,and their satisfaction evaluations of the teaching model(P<0.05).CONCLUSION In a single-center practice,performing the multivariate integration teaching model for medical staff may effectively improve the patients’QLI and satisfaction and may have certain application value in preventing DVT in patients with gastric cancer and PICC.展开更多
BACKGROUND Young-onset type 2 diabetes mellitus(T2DM)is associated with adverse health outcomes and increased mortality.Vitamin D(VitD)deficiency is likewise linked to various adverse health outcomes and is significan...BACKGROUND Young-onset type 2 diabetes mellitus(T2DM)is associated with adverse health outcomes and increased mortality.Vitamin D(VitD)deficiency is likewise linked to various adverse health outcomes and is significantly associated with lipid metabolism in patients with T2DM.However,little is known regarding the me-chanisms of interaction between VitD and apolipoprotein A1(apoA1)in young-onset T2DM.AIM To evaluate the relationship between VitD and apoA1 levels in patients with young-onset T2DM.METHODS This cross-sectional study was conducted at Zhejiang Provincial People’s Hospital between January 2019 and December 2023.A total of 642 patients with T2DM who aged 18-40 years were included and matched with 642 individuals without diabetes(controls)based on age and sex.No specific intervention was applied,and data were collected from medical records and laboratory tests.The re-lationship between VitD and apoA1 levels was examined using Spearman’s correlation and logistic regression models.RESULTS We found that VitD levels were significantly lower in patients with T2DM compared to controls(15.9 ng/mL vs 17.4 ng/mL,P<0.001),with a notable positive correlation between VitD deficiency and reduced apoA1 levels.Multifactor logistic regression analysis identified that severe VitD deficiency was an independent risk factor for apoA1 in young-onset T2DM patients(odds ratio=3.43,95%confidence interval:1.16-10.20,β=1.23,P=0.026).CONCLUSION Our findings reveal an association between VitD and apoA1 in young-onset T2DM,suggesting that VitD may play a crucial role in metabolic regulation and cardiovascular risk management.展开更多
Objective Foreign studies have reported that coronary artery disease(CAD) patients with high baseline low-density lipoprotein cholesterol(LDL-C) may have a good prognosis, which is called the “cholesterol paradox”. ...Objective Foreign studies have reported that coronary artery disease(CAD) patients with high baseline low-density lipoprotein cholesterol(LDL-C) may have a good prognosis, which is called the “cholesterol paradox”. This study aimed to examine whether the “cholesterol paradox” also exists in the Chinese population.Methods A total of 2,056 patients who underwent the first percutaneous coronary intervention(PCI)between 2014 and 2016 were enrolled in this retrospective cohort study and classified into two groups based on baseline LDL-C = 2.6 mmol/L(100 mg/d L). The outcomes of interest included major adverse cardiovascular events(MACE), all-cause mortality, recurrent nonfatal myocardial infarction, unexpected coronary revascularization, or any nonfatal stroke.Results All-cause mortality occurred in 8 patients(0.7%) from the low-LDL-C group and 12 patients(2.4%) in the high-LDL-C group, with a significant difference between the two groups(adjusted hazard ratio: 4.030, 95% confidence interval: 1.088–14.934;P = 0.037). However, no significant differences existed for the risk of MACE or other secondary endpoints, such as unexpected revascularization, nor any nonfatal stroke in the two groups.Conclusion In this study, a high baseline LDL-C was not associated with a low risk of clinical outcomes in CAD patients undergoing first PCI, which suggested that the “cholesterol paradox” may be inapplicable to Chinese populations.展开更多
BACKGROUND Recently,nonalcoholic fatty liver disease(NAFLD)has been renamed metabolicassociated fatty liver disease(MAFLD).Based on the definition for MAFLD,a group of non-obese and metabolically healthy individuals w...BACKGROUND Recently,nonalcoholic fatty liver disease(NAFLD)has been renamed metabolicassociated fatty liver disease(MAFLD).Based on the definition for MAFLD,a group of non-obese and metabolically healthy individuals with fatty liver are excluded from the newly proposed nomenclature.AIM To analyze the histologic features in the MAFLD and non-MAFLD subgroups of NAFLD.METHODS Eighty-three patients with biopsy-proven NAFLD were separated into MAFLD and non-MAFLD groups.The diagnosis of MAFLD was established as hepatic steatosis along with obesity/diabetes or evidence of metabolic dysfunction.The histologic features were compared according to different metabolic disorders and liver enzyme levels.RESULTS MAFLD individuals had a higher NAFLD activity score(P=0.002)and higher severity of hepatic steatosis(42.6%Grade 1,42.6%Grade 2,and 14.8%Grade 3 in MAFLD;81.8%Grade 1,13.6%Grade 2,and 4.5%Grade 3 in non-MAFLD;P=0.007)than the non-MAFLD group.Lobular and portal inflammation,hepatic ballooning,fibrosis grade,and the presence of nonalcoholic steatohepatitis(NASH)and significant fibrosis were comparable between the two groups.The higher the liver enzyme levels,the more severe the grades of hepatic steatosis(75.0%Grade 1 and 25.0%Grade 2 in normal liver function;56.6%Grade 1,39.6%Grade 2,and 3.8%Grade 3 in increased liver enzyme levels;27.8%Grade 1,27.8%Grade 2,and 44.4%Grade 3 in liver injury;P<0.001).Patients with liver injury(alanine aminotransferase>3×upper limit of normal)presented a higher severity of hepatocellular ballooning(P=0.021).Moreover,the grade of steatosis correlated significantly with hepatocellular ballooning degree(r=0.338,P=0.002)and the presence of NASH(r=0.466,P<0.001).CONCLUSION Metabolic dysfunction is associated with hepatic steatosis but no other histologic features in NAFLD.Further research is needed to assess the dynamic histologic characteristics in NAFLD based on the presence or absence of metabolic disorders.展开更多
BACKGROUND Sporadic cases of rheumatoid arthritis(RA)due to unsatisfactory responses to Abatacept(ABT)have been reported;however,the rescue therapy has not been finalized.Here,we present a case with difficult-to-treat...BACKGROUND Sporadic cases of rheumatoid arthritis(RA)due to unsatisfactory responses to Abatacept(ABT)have been reported;however,the rescue therapy has not been finalized.Here,we present a case with difficult-to-treat RA(D2T RA)that was resistant to either a single ABT or a Janus kinase(JAK)inhibitor(Tofacitinib),but improved with a combination of ABT and JAK inhibitor(Baricitinib,BAT).CASE SUMMARY A 46-year-old Chinese woman who had RA for ten years that was resistant to Tocilizumab,Etanercept,Adalimumab,and ABT.According to the European League Against Rheumatism definition,the patient was diagnosed with D2T RA.It was then improved with a combination of ABT and a JAK inhibitor BAT.CONCLUSION ABT combined with BAT may be an acceptable strategy for treating D2T RA.展开更多
In this editorial,we comment on the article by Liu et al.Based on our analysis of a case report,we consider that early screening and recognition of primary nasal tuberculosis are crucial for patients undergoing treatm...In this editorial,we comment on the article by Liu et al.Based on our analysis of a case report,we consider that early screening and recognition of primary nasal tuberculosis are crucial for patients undergoing treatment with tumor necrosis factor inhibitor(TNFi).While TNFi therapy increases the risk of reactivating latent tuberculosis,primary nasal tuberculosis remains rare due to the protective mechanisms of the nasal mucosa.Risk factors for primary nasal tuberculosis include minimally invasive nasal surgery,diabetes,and human immunodefi ciency virus.Patients with early symptoms such as nasal congestion,rhinorrhea,altered olfaction,epistaxis,or ulceration,and unresponsive to conventional antibiotics and antihistamines should undergo early rhinoscopy,possibly followed by repeated tissue biopsies and acid-fast bacilli culture when necessary.When diagnosis is challenging,it is essential to consider local tuberculosis epidemiology and the efficacy of diagnostic antituberculosis treatment.The preferred method for tuberculosis screening is the Interferon Gamma Release Assay,with a general recommendation for screening at 3 and 6 months after initial treatment and then every six months.However,the optimal frequency is not yet consensus-driven and may be increased in economically viable settings.展开更多
Rheumatoid arthritis(RA)is a chronic inflammatory disease characterized by progressive synovial inflammation.It is characterized by dysregulation of inflammatory processes in the synovium of the joints,leading to the ...Rheumatoid arthritis(RA)is a chronic inflammatory disease characterized by progressive synovial inflammation.It is characterized by dysregulation of inflammatory processes in the synovium of the joints,leading to the destruction of articular cartilage and bone erosion,which in turn causes pain and swelling.In severe cases,joint deformity may even occur.展开更多
Metabolic-associated fatty liver disease(MAFLD),a global health burden with limited therapeutic options beyond lifestyle changes,urgently needs novel strategies.We engineered exosome-like nanovesicles(HNVs)from dried ...Metabolic-associated fatty liver disease(MAFLD),a global health burden with limited therapeutic options beyond lifestyle changes,urgently needs novel strategies.We engineered exosome-like nanovesicles(HNVs)from dried honeysuckle(Lonicera japonica),exhibiting significantly more uniform size distribution than conventional herbal extracts and characteristic nanovesicle morphology.Orally delivered HNVs,enriched with bioactive metabolites,dramatically inhibited increased fat vacuoles,lipid droplet deposition,and collagen fibrosis in the livers of mice with MAFLD induced by high-fat diet(HFD).Mechanistically,HNVs orchestrate a dual gut-liver intervention:(1)restoring gut barrier integrity,slashing serum LPS by 1.58-fold and quelling hepatic inflammation;(2)remodeling gut microbiota to suppress bile salt hydrolase(BSH),elevating taurochenodeoxycholic acid(TCDCA)2.07-fold.This microbial shift reprograms enterohepatic signaling by inhibiting the FXR-FGF15-FGFR4 axis,thereby boosting hepatic cholesterol catabolism via bile acid synthases.Critically,efficacy is strictly microbiotadependent:abolished by antibiotics and fully transferable via fecal microbiota transplantation(FMT)from HNV-treated donors.Presenting the first natural nanovesicle platform that concurrently targets gut barrier repair and metabolic reprogramming,HNVs establish a pioneering,multi-targeted therapeutic paradigm for MAFLD,directly linking gut microbial ecology to hepatic pathophysiology with high translational potential.展开更多
基金Supported by Zhejiang Province Traditional Chinese Medicine Science and Technology Plan Project,No.2023ZL230。
文摘BACKGROUND Although gastroscopy is a commonly used diagnostic and therapeutic technique,postoperative gastrointestinal dysfunction is prone to occur.Traditional Chinese medicine theory suggests that postoperative gastrointestinal disorders are related to spleen and stomach weakness.This study hypothesizes that the combination of acupoint application at the Ziwu Liuzhu acupoint and percutaneous acupoint electrical stimulation can promote postoperative gastrointestinal function recovery and alleviate stress reactions.AIM To investigate the effects of acupoint application of Ziwu Liuzhu combined with percutaneous acupoint electrical stimulation on postoperative gastrointestinal function recovery and stress response in patients undergoing gastrointestinal endoscopy surgery.METHODS A total of 120 patients who underwent gastroscopy surgery were selected and treated between October 2024 and January 2025.This study used a stratified block randomization method,and then allocated groups using computer-generated random number sequences(SAS 9.4 software).The groups were divided into two groups:A control group of 60 patients who received routine postoperative intervention measures,and an observation group of 60 patients who received acupuncture point application combined with transcutaneous acupoint electrical CONCLUSION The combination of percutaneous acupoint electrical stimulation in gastroscopy patients has been demonstrated to be both highly safe and effective.The benefits of this approach include the promotion of postoperative gastrointestinal function,the reduction of stress response,the attainment of optimal results,and the enhancement of patient satisfaction.
文摘BACKGROUND Peripherally inserted central catheter(PICC)is the preferred intravenous route for chemotherapy in patients with cancer,but its complications,especially deep vein thrombosis(DVT),are becoming increasingly prevalent.Medical staff proficient in intubation and maintenance techniques can reduce complications.The multivariate integration teaching model applies the integration of“teaching learning application”to medical training,which helps shift the prevention of complications from“passive management of complications”to“active construction of risk immunity”,thereby ensuring foundational competency for PICC in patients with cancer.AIM To investigate the efficacy of the multivariate integration teaching model in patients with gastric cancer and concurrent DVT after PICC intubation and analyze its effect on patients’quality of life index(QLI)and satisfaction.METHODS A retrospective analysis of medical records of 100 patients with gastric cancer and PICC treated at Zhejiang Provincial People’s Hospital from May 2019 to November 2020 was conducted.According to the different treatment methods and teaching modes received by medical staff,they were divided into a control group and an experimental group,with 50 cases in each group.The routine clinical teaching model and the multivariate integration teaching model were administered to the medical staff for the control group and the experimental group,respectively,to compare the incidence rates of DVT and other adverse reactions,QLI scores,Karnofsky Performance Scale scores,Mental Status Scale in Non-Psychiatric Settings scores,patient satisfaction,medical staff’s test marks,and satisfaction evaluation of the teaching model.RESULTS Compared with the control group,the experimental group exhibited significantly lower incidence rates of DVT and other adverse reactions and MSSNS scores but significantly higher QLI scores,KPS scores,patient satisfaction,medical staff’s test marks,and their satisfaction evaluations of the teaching model(P<0.05).CONCLUSION In a single-center practice,performing the multivariate integration teaching model for medical staff may effectively improve the patients’QLI and satisfaction and may have certain application value in preventing DVT in patients with gastric cancer and PICC.
基金Supported by the Medical Science and Technology Project of Zhejiang Province,No.2022KY518General Scientific Research Project of Zhejiang Provincial Education Department,No.Y202352799Medical Science and Technology Project of Zhejiang Province,No.2024KY726.
文摘BACKGROUND Young-onset type 2 diabetes mellitus(T2DM)is associated with adverse health outcomes and increased mortality.Vitamin D(VitD)deficiency is likewise linked to various adverse health outcomes and is significantly associated with lipid metabolism in patients with T2DM.However,little is known regarding the me-chanisms of interaction between VitD and apolipoprotein A1(apoA1)in young-onset T2DM.AIM To evaluate the relationship between VitD and apoA1 levels in patients with young-onset T2DM.METHODS This cross-sectional study was conducted at Zhejiang Provincial People’s Hospital between January 2019 and December 2023.A total of 642 patients with T2DM who aged 18-40 years were included and matched with 642 individuals without diabetes(controls)based on age and sex.No specific intervention was applied,and data were collected from medical records and laboratory tests.The re-lationship between VitD and apoA1 levels was examined using Spearman’s correlation and logistic regression models.RESULTS We found that VitD levels were significantly lower in patients with T2DM compared to controls(15.9 ng/mL vs 17.4 ng/mL,P<0.001),with a notable positive correlation between VitD deficiency and reduced apoA1 levels.Multifactor logistic regression analysis identified that severe VitD deficiency was an independent risk factor for apoA1 in young-onset T2DM patients(odds ratio=3.43,95%confidence interval:1.16-10.20,β=1.23,P=0.026).CONCLUSION Our findings reveal an association between VitD and apoA1 in young-onset T2DM,suggesting that VitD may play a crucial role in metabolic regulation and cardiovascular risk management.
基金supported by the Ethics Committee of Sir Run Run Shaw Hospital of Zhejiang University [NO.20200224-33]Key Project of Medical and Health Science and Technology of Zhejiang Province [NO. WKJ-ZJ-1715]+7 种基金Zhejiang Province Traditional Chinese Medicine Science and Technology Project [NO. 2017ZA006]Natural Science Foundation of Zhejiang Province [NO. LQ17H020006]Medical health Science and Technology project of Zhejiang Province [NO. 2017KY207]National Natural Science Foundation of China [82070408]Medical and health project [2021RC014]Hangzhou Medical Health Science and Technology Project [B20200116]“Pioneer” and “Leading Goose” R&D Program of Zhejiang[2023C04013]Administration of Traditional Chinese Medicine of Zhejiang Province [GZY-ZJ-KJ-23001]。
文摘Objective Foreign studies have reported that coronary artery disease(CAD) patients with high baseline low-density lipoprotein cholesterol(LDL-C) may have a good prognosis, which is called the “cholesterol paradox”. This study aimed to examine whether the “cholesterol paradox” also exists in the Chinese population.Methods A total of 2,056 patients who underwent the first percutaneous coronary intervention(PCI)between 2014 and 2016 were enrolled in this retrospective cohort study and classified into two groups based on baseline LDL-C = 2.6 mmol/L(100 mg/d L). The outcomes of interest included major adverse cardiovascular events(MACE), all-cause mortality, recurrent nonfatal myocardial infarction, unexpected coronary revascularization, or any nonfatal stroke.Results All-cause mortality occurred in 8 patients(0.7%) from the low-LDL-C group and 12 patients(2.4%) in the high-LDL-C group, with a significant difference between the two groups(adjusted hazard ratio: 4.030, 95% confidence interval: 1.088–14.934;P = 0.037). However, no significant differences existed for the risk of MACE or other secondary endpoints, such as unexpected revascularization, nor any nonfatal stroke in the two groups.Conclusion In this study, a high baseline LDL-C was not associated with a low risk of clinical outcomes in CAD patients undergoing first PCI, which suggested that the “cholesterol paradox” may be inapplicable to Chinese populations.
基金Supported by the National Natural Science Foundation of China,No.81800507the Public Welfare Project of the Science and Technology Agency,Zhejiang Province,No.LGF18H030010Medical and Health Research Project of Zhejiang Province,No.2018KY256 and No.2019KY294.
文摘BACKGROUND Recently,nonalcoholic fatty liver disease(NAFLD)has been renamed metabolicassociated fatty liver disease(MAFLD).Based on the definition for MAFLD,a group of non-obese and metabolically healthy individuals with fatty liver are excluded from the newly proposed nomenclature.AIM To analyze the histologic features in the MAFLD and non-MAFLD subgroups of NAFLD.METHODS Eighty-three patients with biopsy-proven NAFLD were separated into MAFLD and non-MAFLD groups.The diagnosis of MAFLD was established as hepatic steatosis along with obesity/diabetes or evidence of metabolic dysfunction.The histologic features were compared according to different metabolic disorders and liver enzyme levels.RESULTS MAFLD individuals had a higher NAFLD activity score(P=0.002)and higher severity of hepatic steatosis(42.6%Grade 1,42.6%Grade 2,and 14.8%Grade 3 in MAFLD;81.8%Grade 1,13.6%Grade 2,and 4.5%Grade 3 in non-MAFLD;P=0.007)than the non-MAFLD group.Lobular and portal inflammation,hepatic ballooning,fibrosis grade,and the presence of nonalcoholic steatohepatitis(NASH)and significant fibrosis were comparable between the two groups.The higher the liver enzyme levels,the more severe the grades of hepatic steatosis(75.0%Grade 1 and 25.0%Grade 2 in normal liver function;56.6%Grade 1,39.6%Grade 2,and 3.8%Grade 3 in increased liver enzyme levels;27.8%Grade 1,27.8%Grade 2,and 44.4%Grade 3 in liver injury;P<0.001).Patients with liver injury(alanine aminotransferase>3×upper limit of normal)presented a higher severity of hepatocellular ballooning(P=0.021).Moreover,the grade of steatosis correlated significantly with hepatocellular ballooning degree(r=0.338,P=0.002)and the presence of NASH(r=0.466,P<0.001).CONCLUSION Metabolic dysfunction is associated with hepatic steatosis but no other histologic features in NAFLD.Further research is needed to assess the dynamic histologic characteristics in NAFLD based on the presence or absence of metabolic disorders.
文摘BACKGROUND Sporadic cases of rheumatoid arthritis(RA)due to unsatisfactory responses to Abatacept(ABT)have been reported;however,the rescue therapy has not been finalized.Here,we present a case with difficult-to-treat RA(D2T RA)that was resistant to either a single ABT or a Janus kinase(JAK)inhibitor(Tofacitinib),but improved with a combination of ABT and JAK inhibitor(Baricitinib,BAT).CASE SUMMARY A 46-year-old Chinese woman who had RA for ten years that was resistant to Tocilizumab,Etanercept,Adalimumab,and ABT.According to the European League Against Rheumatism definition,the patient was diagnosed with D2T RA.It was then improved with a combination of ABT and a JAK inhibitor BAT.CONCLUSION ABT combined with BAT may be an acceptable strategy for treating D2T RA.
文摘In this editorial,we comment on the article by Liu et al.Based on our analysis of a case report,we consider that early screening and recognition of primary nasal tuberculosis are crucial for patients undergoing treatment with tumor necrosis factor inhibitor(TNFi).While TNFi therapy increases the risk of reactivating latent tuberculosis,primary nasal tuberculosis remains rare due to the protective mechanisms of the nasal mucosa.Risk factors for primary nasal tuberculosis include minimally invasive nasal surgery,diabetes,and human immunodefi ciency virus.Patients with early symptoms such as nasal congestion,rhinorrhea,altered olfaction,epistaxis,or ulceration,and unresponsive to conventional antibiotics and antihistamines should undergo early rhinoscopy,possibly followed by repeated tissue biopsies and acid-fast bacilli culture when necessary.When diagnosis is challenging,it is essential to consider local tuberculosis epidemiology and the efficacy of diagnostic antituberculosis treatment.The preferred method for tuberculosis screening is the Interferon Gamma Release Assay,with a general recommendation for screening at 3 and 6 months after initial treatment and then every six months.However,the optimal frequency is not yet consensus-driven and may be increased in economically viable settings.
基金Supported by the Department of Science and Technology of State Administration of Traditional Chinese Medicine-Joint Science and Technology Plan of Zhejiang Provincial Administration of Traditional Chinese Medicine(No.GZY-ZJ-KJ-23044)the Zhejiang Provincial Natural Science Foundation(No.Y21H270014)the National Key R&D Program(No.2022YFC3501204)。
文摘Rheumatoid arthritis(RA)is a chronic inflammatory disease characterized by progressive synovial inflammation.It is characterized by dysregulation of inflammatory processes in the synovium of the joints,leading to the destruction of articular cartilage and bone erosion,which in turn causes pain and swelling.In severe cases,joint deformity may even occur.
基金supported by the Zhejiang Provincial Natural Science Foundation of China(No.KLZ25H280004 to X.Z.M.).
文摘Metabolic-associated fatty liver disease(MAFLD),a global health burden with limited therapeutic options beyond lifestyle changes,urgently needs novel strategies.We engineered exosome-like nanovesicles(HNVs)from dried honeysuckle(Lonicera japonica),exhibiting significantly more uniform size distribution than conventional herbal extracts and characteristic nanovesicle morphology.Orally delivered HNVs,enriched with bioactive metabolites,dramatically inhibited increased fat vacuoles,lipid droplet deposition,and collagen fibrosis in the livers of mice with MAFLD induced by high-fat diet(HFD).Mechanistically,HNVs orchestrate a dual gut-liver intervention:(1)restoring gut barrier integrity,slashing serum LPS by 1.58-fold and quelling hepatic inflammation;(2)remodeling gut microbiota to suppress bile salt hydrolase(BSH),elevating taurochenodeoxycholic acid(TCDCA)2.07-fold.This microbial shift reprograms enterohepatic signaling by inhibiting the FXR-FGF15-FGFR4 axis,thereby boosting hepatic cholesterol catabolism via bile acid synthases.Critically,efficacy is strictly microbiotadependent:abolished by antibiotics and fully transferable via fecal microbiota transplantation(FMT)from HNV-treated donors.Presenting the first natural nanovesicle platform that concurrently targets gut barrier repair and metabolic reprogramming,HNVs establish a pioneering,multi-targeted therapeutic paradigm for MAFLD,directly linking gut microbial ecology to hepatic pathophysiology with high translational potential.
