Objective To evaluate the cost–utility of lecanemab and donanemab in the treatment of early Alzheimer’s disease （AD） in China. Methods A Markov model was developed from a societal perspective to compare standard of care （SOC）, lecanemab plus SOC, and donanemab plus SOC in terms of costs, quality-adjusted life years （QALY）, and incremental cost–utility ratios （ICUR）. Deterministic and probabilistic sensitivity analyses were conducted to assess parameter uncertainty. Results Both intervention strategies increased QALY compared with SOC but were associated with substantially higher costs, and neither was cost-effective under the current willingness-to-pay threshold. Conclusion Lecanemab and donanemab may be more appropriately considered within a multi-tiered healthcare reimbursement framework in China rather than relying solely on basic medical insurance.

Objective To explore the similarity between young fruits of Citrus aurantium'Changshan-huyou'and Pharmacopoeia origin Aurantii Fructus Immaturus.Methods The fingerprints of young fruits of Citrus aurantium'Changshan-huyou'and the Pharmacopoeia origin Aurantii Fructus Immaturus were established by high performance liquid chromatography(HPLC).The similarity analysis was carried out by using the software of Traditional Chinese medicine chromatographic fingerprint similarity evaluation system.The whole components of young fruit of Citrus aurantium'Changshan-huyou'and the Pharmacopoeia origin Aurantii Fructus Immaturus were compared by using chemometrics,and the 14 compounds were analyzed quantitatively.Results ①The results of similarity and cluster analysis were affected by the origin and producing area,for example,the similarity between citrus sinensis(L.)Osbeck and other origin was only 0.2,the similarity of citrus aurantium L.from different producing areas ranged from 0.802 to 0.986,with relative large dispersion;②young fruit of Citrus aurantium'Changshan-huyou',some citrus aurantium L.,citrus aurantium L.cv.Daidai,stink orange and citrus aurantium L.cv.Zhulan all belong to the same category,and the similarity was above 0.9;③VIP method screened out 21 common peaks that had important effects on quality,mainly including neohesperidin,naringin,umbellitin,tangeretin,hesperidin hydrate and hesperidin.The quantitative analysis results showed that Naringin and neohesperidin were abundant in young fruits of Citrus aurantium'Changshan-huyou'and Aurantii Fructus Immaturus,followed by hesperidin and naringin,there were significant differences in the content of principal components among Aurantii Fructus Immaturus from different origins,especially in citrus sinensis(L.)Osbeck,the young fruits of Citrus aurantium'Changshan-huyou'was relatively stable.Conclusion The young fruits of Citrus aurantium'Changshan-huyou'had good similarity with most origin of Aurantii Fructus Immaturus,so it is feasible to be used as Aurantii Fructus Immaturus.

Corneal endothelial cells act as an ion pump and barrier to maintain corneal transparency and normal physiological function.Once injured, adult corneal endothelial cells are compensated by the migration and expansion of peripheral cells.Excessive injury leads to corneal endothelial decompensation, resulting in corneal edema and visual loss.At present, the common treatment is corneal endothelial transplantation.In recent years, the mechanism of endothelial cell proliferation, differentiation and adhesion has been extensively studied.Alternative therapies for corneal transplantation have also been proposed, including endothelial cell regeneration, induced pluripotent stem cell differentiation, cell transplantation, tissue engineering, and artificial endothelial layer.Cell transplantation and artificial endothelial layer have been approved for clinical trials, while others are still in the basic research stage and their clinical effects are still uncovered.This article reviews the research progress on corneal endothelial cell decompensation in order to find a solution to the shortage of corneal donors and to achieve clinical transformation of scientific research results as soon as possible.

Objective To investigate the impact of hepatopancreatic ampulla features on difficult biliary cannulation during endoscopic retrograde cholangiopancreatography(ERCP).Methods A retrospective analysis was conducted on 800 patients who underwent ERCP from June 2023 to April 2024.Hepatopancreatic ampullary features were categorized endoscopically into four types:1)Non-protruding(n=544);2)Protruding(n=120);3)Diverticula or mucosal folds(n=96);4)Tortuosity or tumor involvement(n=40).Standard biliary cannulation was initiated in all cases,with failure defined as difficult cannulation.Advanced cannulation techniques were employed for all difficult cannulation cases[double-guidewire technique(DGT)or precutsphincterotomy(PST)].Success rates and procedural complications were recorded.Results Standard biliary cannulation outcomes,success rates 79.96％(435/544)in non-protruding vs.69.17％(83/120)in protruding,72.92％(70/96)in diverticula or mucosal folds,and 65.00％(26/40)in tortuosity or tumor groups(x2=10.90,P=0.012);Difficult cannulation rates 18.01％(98/544)in non-protruding vs.27.50％(33/120)in protruding,27.08％(26/96)in diverticula or mucosal folds,and 30.00％(12/40)in tortuosity or tumor groups(x2=10.41,P=0.015).In the subgroups,the rates of DGT intubation in the four groups were 11.95％(65/544),15.83％(19/120),12.50％(12/96),and 20.00％(8/40),respectively.There was no statistically significant difference in the success rate of DGT intubation between the groups(x2=6.96,P=0.073).In the subgroups,the PST intubation rates were 6.07％(33/544),11.67％(14/120),14.58％(14/96),and 10.00％(4/40),respectively.There was no statistically significant difference in the success rate of PST intubation between the groups(x2=5.54,P=0.136).Advanced cannulation techniques were used in 169 patients,DGT success rates of 94.23％(98/104)vs.PST at 89.23％(58/65)(x2=19.50,P=0.021);PEP incidence 18.34％(31/169)in difficult cannulation vs.2.61％(16/614)in standard group(x2=58.64,P=0.000);No significant difference in PEP between DGT(21.25％)and PST(13.85％)groups(x2=1.17,P=0.279).Conclusion Hepatopancreatic ampulla features influences biliary cannulation success.Non-protruding ampullae demonstrate optimal outcomes with standard techniques.Notably,DGT and PST are associated with elevated PEP risks in difficult cannulation.

Corneal endothelial cells act as an ion pump and barrier to maintain corneal transparency and normal physiological function.Once injured, adult corneal endothelial cells are compensated by the migration and expansion of peripheral cells.Excessive injury leads to corneal endothelial decompensation, resulting in corneal edema and visual loss.At present, the common treatment is corneal endothelial transplantation.In recent years, the mechanism of endothelial cell proliferation, differentiation and adhesion has been extensively studied.Alternative therapies for corneal transplantation have also been proposed, including endothelial cell regeneration, induced pluripotent stem cell differentiation, cell transplantation, tissue engineering, and artificial endothelial layer.Cell transplantation and artificial endothelial layer have been approved for clinical trials, while others are still in the basic research stage and their clinical effects are still uncovered.This article reviews the research progress on corneal endothelial cell decompensation in order to find a solution to the shortage of corneal donors and to achieve clinical transformation of scientific research results as soon as possible.

Objective To investigate the impact of hepatopancreatic ampulla features on difficult biliary cannulation during endoscopic retrograde cholangiopancreatography(ERCP).Methods A retrospective analysis was conducted on 800 patients who underwent ERCP from June 2023 to April 2024.Hepatopancreatic ampullary features were categorized endoscopically into four types:1)Non-protruding(n=544);2)Protruding(n=120);3)Diverticula or mucosal folds(n=96);4)Tortuosity or tumor involvement(n=40).Standard biliary cannulation was initiated in all cases,with failure defined as difficult cannulation.Advanced cannulation techniques were employed for all difficult cannulation cases[double-guidewire technique(DGT)or precutsphincterotomy(PST)].Success rates and procedural complications were recorded.Results Standard biliary cannulation outcomes,success rates 79.96％(435/544)in non-protruding vs.69.17％(83/120)in protruding,72.92％(70/96)in diverticula or mucosal folds,and 65.00％(26/40)in tortuosity or tumor groups(x2=10.90,P=0.012);Difficult cannulation rates 18.01％(98/544)in non-protruding vs.27.50％(33/120)in protruding,27.08％(26/96)in diverticula or mucosal folds,and 30.00％(12/40)in tortuosity or tumor groups(x2=10.41,P=0.015).In the subgroups,the rates of DGT intubation in the four groups were 11.95％(65/544),15.83％(19/120),12.50％(12/96),and 20.00％(8/40),respectively.There was no statistically significant difference in the success rate of DGT intubation between the groups(x2=6.96,P=0.073).In the subgroups,the PST intubation rates were 6.07％(33/544),11.67％(14/120),14.58％(14/96),and 10.00％(4/40),respectively.There was no statistically significant difference in the success rate of PST intubation between the groups(x2=5.54,P=0.136).Advanced cannulation techniques were used in 169 patients,DGT success rates of 94.23％(98/104)vs.PST at 89.23％(58/65)(x2=19.50,P=0.021);PEP incidence 18.34％(31/169)in difficult cannulation vs.2.61％(16/614)in standard group(x2=58.64,P=0.000);No significant difference in PEP between DGT(21.25％)and PST(13.85％)groups(x2=1.17,P=0.279).Conclusion Hepatopancreatic ampulla features influences biliary cannulation success.Non-protruding ampullae demonstrate optimal outcomes with standard techniques.Notably,DGT and PST are associated with elevated PEP risks in difficult cannulation.

Spine fracture and dislocation are common traumatic spinal conditions that often require surgical intervention due to compromised spinal stability. Surgical approaches include anterior, posterior, and combined anterior-posterior spinal procedures. According to the specific surgical requirements, patients may be placed in the prone position or repositioned between prone and supine positions during surgery. Intraoperative repositioning has become an essential step in patient positioning. However, during repositioning, patients with spinal fracture and dislocation are at increased risk for complications such as hemodynamic instability, nerve injury, and pressure injuries to the skin and soft tissue. Notably, due to the instability of the spinal cord, even minor manipulations can further exacerbate the damage, potentially leading to severe outcomes like paraplegia. Although the current clinical guidelines provide instructive recommendations for standard position, there remains no specific protocols for intraoperative repositioning in patients with spine fracture and dislocation. With a concern for the lack of clinical studies on positioning techniques, risk prevention, and operational norms for special patients, no applicable guidelines or standards are available. A consensus was required to provide clinical reference, meet the requirements of surgical treatment, and minimize the safety risks of patients caused by improper placement of positions. Professional Committee of Operating Room Nursing of Shaanxi Nursing Association organized experts in nursing management and operating room nursing from major hospitals across China to formulate Expert consensus on intraoperative repositioning for patients with spinal fracture and dislocation ( version 2025). The consensus provides 11 recommendations covering pre-repositioning preparation, intraoperative maneuvers, and post-repositioning observation, aiming to provide references for clinical standardization of the intraoperative repositioning process and protection of patients′ safety.

Since 1973,the World Symposium on Pulmonary Hypertension(WSPH)has served as a pivotal platform for the advancing research in pulmonary hypertension(PH).At the 6th WSPH in 2018,the WSPH expert group refined the definitions related to cardiopulmonary physiology and right ventricular(RV)failure,thereby underscoring the critical role of RV dysfunction in the progression of PH.With ongoing advances in the field,RV failure associated with PH has received increasing attention and is now recognized as an important determinant of the prognosis of PH.The 7th WSPH,held in Barcelona,Spain,in 2024,presented the latest perspectives on the RV pathophysiology and its interaction with the pulmonary vasculature.The symposium emphasized new insights into the pathology of RV failure,RV phenotypes across different PH subgroups,and progress in therapeutic approaches targeting RV dysfunction.Additionally,the WSPH expert group delineated prospective research directions and identified unresolved issues.This article will review the RV function-related updates from the 7th WSPH and summarize recent findings,providing a systematic review of the evolution and breakthroughs in RV function research within the context of PH.

Objective To explore the roles of the mechanoreceptor Yes-associated protein 1(YAP1)and piezo type mechanosensitive ion channel component 2(PIEZO2)in mechanotransduction in mouse bladder urothelial cells.Methods Mouse bladder urothelial cells were subjected to mechanical stretching using the FX-6000T cell stretching system and treated with the YAP1-specific inhibitor verteporfin(VP).The expressions of PIEZO2,YAP1 and connective tissue growth factor(CTGF)at the mRNA and protein levels,as well as changes in cellular adenosine triphosphatase(ATP)concentration,were detected using reverse transcription quantitative PCR(RT-qPCR)and Western blotting(WB).Results After stretching stimulation,under the fluorescence microscope,it was observed that the diameter length of the stretched cells were longer than that before stretching,and the difference was statistically significant(P＜0.05).The expressions of YAP1,PIEZO2 and CTGF at the mRNA and protein levels were increased in the stretched group compared to those of the non-stretched group(P＜0.05).VP effectively reduced the expressions of YAP1,PIEZO2 and CTGF at the mRNA and protein levels after stretching stimulation(P＜0.05).Stretching stimulation significantly increased the intracellular ATP concentration,while VP was able to inhibit the increase in ATP concentration,with a statistically significant difference(P＜0.000 1).Conclusion Stretching stimulation increased the expressions of YAP1 and PIEZO2 in bladder urothelial cells and promoted the release of ATP;verteporfin inhibited the increase in YAP1 activity and the overexpression of PIEZO2 caused by stretching,thereby reducing the release of ATP.It is suggested that mouse bladder urothelial cells may primarily sense mechanical signals through the YAP1-PIEZO2-ATP pathway.

Aim To explore the therapeutic effects of resveratrol(Res)on hepatic inflammation and oxida-tive stress in rheumatoid arthritis(RA),and to eluci-date the relationship of the regulatory mechanism of the Nrf2/Keap1 signaling pathway in it.Methods A mouse model of arthritis was induced using chicken type Ⅱ collagen in combination with complete Freund's adjuvant,and Res was administered by tube feeding for treatment.Serum liver function indices and levels of hepatic inflammation and oxidative stress were detected in mice.An in vitro cellular model of hepatic inflam-mation and oxidative stress was established by treating mouse primary hepatocytes(MPHs)with TNF-α(5μg·L-1),cell proliferation inhibition was detected by CCK-8,and inflammation and oxidative stress-relat-ed indices were detected by protein blotting.The in-trinsic mechanisms by which Res attenuated hepatic in-flammation and oxidative stress in rheumatoid arthritis were explored by treating MPHs with Nrf2 inhibitor and Keap1 overexpression plasmid.Results Res signifi-cantly reduced the levels of inflammation and oxidative stress in hepatic tissues of collagen-induced arthritis mice as well as TNF-α-treated MPHs,and activated the Nrf2/Keap1 signaling pathway.Inflammation and oxidative stress levels in MPHs were exacerbated by the use of Nrf2 inhibitors and Keap1 overexpression,which promoted apoptosis.Conclusion Res attenuates he-patic inflammation and oxidative stress in rheumatoid arthritis via the Nrf2/Keap1 pathway.