Glioma is the most common primary malignant tumor of the central nervous system in adults. Despite the standard treatment of surgery combined with radiotherapy and chemotherapy, the prognosis for high-grade glioma patients remains poor, highlighting the urgent need to further explore its pathogenesis and develop new therapeutic strategies. This article reviews the research progress in the field of glioma in China in 2024, covering tumorigenesis mechanisms, tumor immune microenvironment composition, advances in imaging techniques and novel imaging agents, improvements in surgical approaches, mechanisms of radio- and chemoresistance, and explorations of new therapeutic modalities. These studies provide a solid theoretical foundation for advancing clinical diagnosis and treatment of gliomas and may offer new opportunities to improve patient outcomes.

OBJECTIVE To establish a comprehensive evaluation system for lipid-lowering drugs aligned with the clinical reality of Liaoning province， and to assess the commonly used lipid-lowering drugs in medical institutions within Liaoning province. METHODS A comprehensive evaluation system for lipid-lowering drugs of Liaoning province was established using literature analysis and the Delphi expert consultation method. A calculation method of “indicator weighted score” to “step-by-step aggregation” to “percentile standardization” was employed to enable horizontal comparison of 49 commonly used lipid-lowering drugs. RESULTS This study successfully established a comprehensive clinical evaluation system for lipid-lowering drugs of Liaoning province， comprising 7 first-level indicators， 35 second-level indicators， and 116 scoring criteria. Among the first-level indicators， effectiveness （23%） had the highest weight， followed sequentially by safety （22%）， innovativeness （15%）， economy （13%）， suitability （13%）， accessibility （10%）， and other attributes （4%）. Among the 49 evaluated lipid-lowering drugs， the top 10 in overall score were all statins， with rosuvastatin calcium tablet B having the highest total score of 79.22. Inclisiran sodium injection had a total score of 57.14， performed outstandingly in safety （16.27） and innovativeness （11.27）. CONCLUSIONS This study established a relatively comprehensive and detailed clinical evaluation system for lipid-lowering drugs of Liaoning province. Statins remain the cornerstone of lipid management. Most patients can primarily choose drugs like rosuvastatin tablet B， while PCSK9 inhibitors and fixed-dose combinations can be considered for patients with conventional treatment failure or statin intolerance.

Objective:To discuss the changes of adenosine deaminase 2(ADA2)activity in the serum of the systemic lupus erythematosus(SLE)patients,and to clarify its clinical value in the diagnosis and disease assessment of the SLE patients.Methods:According to the inclusion and exclusion criteria,69 SLE patients(SLE group)and 69 healthy controls(control group)were enrolled as study subjects.The disease activity of SLE patients was evaluated by SLE Disease Activity Index(SLEDAI).The ADA2 activity in the serum of the subjects in both groups was detected.The patients were further divided into subgroups based on the presence or absence of the following clinical symptoms:arthritis,myositis,hematuria,proteinuria,pyuria,alopecia,new rash,mucosal ulcer,pleuritis,hypocomplementemia,elevated anti-double-stranded DNA(anti-dsDNA)antibody,thrombocytopenia,and leukopenia.The differences in serum ADA2 activity between joint symptomatic group and joint asymptomatic group were analyzed.The diagnostic efficacy of serum ADA2 activity was evaluated by receiver operating characteristic(ROC)curve analysis.The correlation between ADA2 activity and disease activity in the SLE patients was analyzed by Spearman correlation analysis.Results:Compared with control group,the ADA2 activity in the serum of the patients in SLE group was significantly increased(P<0.01).The ROC analysis results showed that when the cut-off value of ADA2 activity was set at 8.5 U·L-1,the diagnostic performance was optimal,with an area under the curve(AUC)of 0.879(95%CI:0.817-0.940),the specificity was 89.86%,and the sensitivity was 75.36%.The serum ADA2 activity was positively correlated with disease activity in the SLE patients(r=0.32,P=0.007).The subgroup analysis of clinical symptoms results showed that the serum ADA2 activity in the SLE patients with symptoms was significantly higher than that in the SLE patients without symptoms(P<0.01).No significant differences were observed in serum ADA2 activity between the SLE patients with and without myositis,hematuria,proteinuria,pyuria,alopecia,new rash,mucosal ulcer,pleuritis,hypocomplementemia,elevated anti-dsDNA antibody,thrombocytopenia,or leukopenia(P>0.05).Conclusion:The serum ADA2 activity is increased in the SLE patients and can serve as a diagnostic marker for SLE.Serum ADA2 activity is positively correlated with disease activity and is associated with arthritis in the SLE patients,suggesting its potential as an indicator for disease assessment and monitoring.

Objective:To investigate the effect of polystyrene microplastics(PS-MPs)combined with high-fat treatment on vascular endothelial cells.Methods:Human umbilical vein endothelial cells(HUVECs)were cultured in the DMEM medium containing 5%fe-tal bovine serum.HUVECs were treated with conventional culture,high-fat treatment,and PS-MPs combined with high-fat treatment.The experiment was conducted in the three groups of control group,high-fat treatment group and PS-MPs+high-fat treatment group.CCK-8 assay was used to measure cell viability,F-actin staining was used to observe cell morphological changes,and flow cytometry,scratch assay,and tube formation assay were used to measure the apoptosis,migration,and tube-forming ability of cells.Results:After HUVECs were exposed to the high-fat environment,there was a significant reduction in cell viability,shrinkage of cells,a signifi-cant increase in cell apoptosis,and significant reductions in cell migration and tube-forming ability.Compared with the high-fat treat-ment group,there were no significant changes in cell viability,cell morphology,cell apoptosis,and cell migration ability after PS-MPs combined with high-fat treatment,but the tube-forming ability of cells was further impaired.Conclusion:High-fat treatment will affect cell viability,change cell morphology,and damage vascular endothelial cell function,and PS-MPs combined with high-fat treat-ment can aggravate the damage of vascular endothelial cell function.

Objective:To analyze the revision strategies for failed atlantoaxial dislocation (AAD) surgery.Methods:A retrospective analysis was conducted on 145 patients who underwent revision surgery for AAD at the General Hospital of Southern Theatre Command of PLA between September 2009 and December 2023. The cohort included 74 males and 71 females, with a mean age of 43±16 years (range, 6-72 years). The initial surgical approaches were: anterior 31 cases, posterior 114 cases. Based on imaging assessments of immediate postoperative reduction and fusion status prior to revision, the cases of failure were classified into reduction-nonfusion type (22 cases), nonreduction-fusion type (31 cases), and nonreduction-nonfusion type (92 cases). Among the nonreduction-nonfusion cases, 39 had initial surgery with internal fixation for reduction, while 53 had initial surgery with simple decompression (posterior arch resection, foramen magnum decompression) without reduction. In the nonreduction-fusion cases, 8 cases had spot fusion and 23 had extensive fusion. Japanese Orthopaedic Association (JOA) scores were compared before and after revision, and complication rates were observed.Results:All patients successfully underwent surgery. The revision approaches included: anterior (anterior fixation and fusion 52 cases, anterior implant removal combined anterior fixation and fusion 4 cases, transoral odontoidectomies 16 cases, anterior implant removal combined transoral odontoidectomy 2 cases), posterior (posterior fixation and fusion 2 cases, posterior implant removal combined posterior fixation and fusion 22 cases), and combined anterior-posterior (posterior implant removal combined anterior fixation and fusion 18 cases, anterior implant removal combined posterior fixation and fusion 25 cases, posterior implant removal combined transoral odontoidectomy 5 cases). Operative time was 254.20±107.63 min (range, 90-660 min), and blood loss was 218.83±172.17 ml (range, 20-800 ml). Except for 3 patients who died due to postoperative complications, all patients were followed up for a duration of 12±11 months (range, 3-60 months). Six patients who failed to achieve bony fusion after the initial revision surgery underwent a second revision due to poor reduction (1 case), infection (1 case), suboptimal implant position (3 cases), and graft nonunion (1 case). All three patients with bony fusion after the initial revision surgery underwent a second revision due to poor reduction. Following the second revision surgery, none of the 9 patients exhibited graft nonunion or spinal cord compression. The 136 successful initial revision cases had a final follow-up JOA score of 14.75±2.00, significantly higher than the preoperative score of 11.93±2.92 ( t=-18.869, P<0.001). Conclusions:Revision surgery for AAD should take into account the immediate postoperative reduction status and fusion status prior to revision. An appropriate revision strategy should be selected to achieve satisfactory reduction and bony fusion.

Reporting guidelines are structured checklists for researchers to follow when reporting spe-cific types of studies.As researches conducted in real-world settings to address practical issues,implementa-tion research has stringent requirements for the replicability of result and the transparency of reporting,making its reporting guidelines particularly important.This paper systematically introduces the reporting guidelines in the field of implementation science,outlines their classification systems and scopes of applica-tion,and focuses on explaining the core characteristics and functions of five key reporting guidelines,inclu-ding the Standards for Reporting Implementation Studies(StaRI),Reporting guidelines for implementation and operational research,the Template for Intervention Description and Replication(TIDieR),the Frame-work for Reporting Adaptations and Modifications-Enhanced(FRAME),and recommendations for specifying and reporting implementation strategies.Furthermore,combined with the PEDALs research paradigm in im-plementation science,this paper further clarifies the specific application pathways for reporting guidelines and discusses directions for refinement,aiming to provide references for researchers to select appropriate reporting guidelines.

In recent years, significant progress has been made in pharmacological research on the treatment of ischemic stroke with monomeric components of traditional Chinese medicine, among which flavonoids have shown good neuroprotective effects. This article reviews the regulatory role of flavonoids in the signaling pathway of ischemic brain injury.

The glymphatic system (GS) is an essential waste clearance pathway in the central nervous system, playing a crucial role in the occurrence and progression of cerebrovascular diseases. In recent years, advancements in imaging techniques have provided important tools for assessing the structure and dynamics of the GS, further advancing its research in patients with cerebrovascular disease. This article reviews various imaging evaluation methods and clinical significance of GS in patients with cerebrovascular disease, aiming to provide a new perspective for a deeper understanding of the pathophysiological mechanisms and clinical practice of cerebrovascular disease.

Elemene is widely recognized as an effective anti-cancer compound and is routinely administered in Chinese clinical settings for the management of several solid tumors,including non-small cell lung cancer(NSCLC).However,its detailed molecular mechanism has not been adequately demonstrated.In this research,it was demonstrated that elemene effectively curtailed NSCLC growth in the patient-derived xenograft(PDX)model.Mechanistically,employing high-throughput screening techniques and subsequent biochemical validations such as microscale thermophoresis(MST),microRNA-145-5p(miR-145-5p)was pinpointed as a critical target through which elemene exerts its anti-tumor effects.Inter-estingly,elemene serves as a binding stabilizer for miR-145-5p,demonstrating a strong binding affinity(dissociation constant(KD)=0.39±0.17 μg/mL)and preventing its degradation both in vitro and in vivo,while not interfering with the synthesis of the primary microRNA transcripts(pri-miRNAs)and precursor miRNAs(pre-miRNAs).The stabilization of miR-145-5p by elemene resulted in an increased level of this miRNA,subsequently suppressing NSCLC progression through the miR-145-5p/mitogen-activated pro-tein kinase kinase kinase 3(MAP3K3)/nuclear factor kappaB(NF-κB)pathway.Our findings provide a new perspective on revealing the interaction patterns between clinical anti-tumor drugs and miRNAs.

Metastasis serves as an indicator of malignancy and is a biological characteristic of carcinomas. Epithelial-mesenchymal transition (EMT) plays a key role in the promotion of tumor invasion and metastasis and in the enhancement of tumor cell aggressiveness. Prostaglandin E synthase 3 (p23) is a cochaperone for heat shock protein 90 (HSP90). Our previous study showed that p23 is an HSP90-independent transcription factor in cancer-associated inflammation. The effect and mechanism of action of p23 on lung cancer metastasis are tested in this study. By utilizing cell models in vitro and mouse tail vein metastasis models in vivo, the results provide solid evidence that p23 is critical for promoting lung cancer metastases by regulating downstream CXCL1 expression. Rather than acting independently, p23 forms a complex with RNA-binding motif protein 14 (RBM14) to facilitate EMT progression in lung cancer. Therefore, our study provides evidence for the potential role of the RBM14-p23-CXCL1-EMT axis in the metastasis of lung cancer.