OBJECTIVE To investigate the mechanism of pachymic acid on renal injury in pregnancy induced hypertension （PIH） rats by regulating the silent information regulator transcript 1/peroxisome proliferator-activated receptor γ coactivator-1α （Sirt1/PGC-1α） pathway. METHODS Pregnant SD rats were prepared by co-caging and PIH model was induced using N-nitro-L- arginine methyl ester （L-NAME） method. PIH rats were randomly divided into model group， L-pachymic acid （low-dose pachymic acid， 10 mg/kg） group， H-pachymic acid （high-dose pachymic acid， 20 mg/kg） group， and H-pachymic acid+EX527 （20 mg/kg pachymic acid+10 mg/kg EX527） group， with 6 rats in each group. Another 6 normal pregnant rats were selected as blank group. Each group was given relevant medicine or solvent intragastrically or intraperitoneally daily， once a day， for 28 consecutive days. After the last administration， 24 h urinary protein and tail artery systolic blood pressure （SBP） were measured in pregnant rats from each group， along with the levels of serum creatinine （Scr）， blood urea nitrogen （BUN），uric acid （UA）， and cystatin C （Cys-C）. The contents of superoxide dismutase （SOD）， malondialdehyde （MDA）， glutathione peroxidase （GSH-Px）， and 8-hydroxy-2′-deoxyguanosine （8-OHdG） in renal tissue， as well as the mRNA and protein expression levels of Sirt1 and PGC-1α， were also determined. Meanwhile， renal histopathological changes in rats from each group were evaluated using hematoxylin-eosin （HE） staining and periodic acid-Schiff （PAS） staining. RESULTS Compared with model group， L-pachymic acid group and H-pachymic acid group exhibited significant decreases in 24 h urine protein quantification， tail artery SBP， Scr， BUN， UA， Cys-C levels， glomerulosclerosis index score of renal tissue， renal tubular injury score， the percentage of PAS positive area， MDA and 8-OHdG （P＜0.05）. Conversely， the contents of SOD and GSH-Px， along with the mRNA and protein expression levels of Sirt1 and PGC-1α， were significantly increased （P＜0.05）. Moreover， these improvements were more pronounced in H-pachymic acid group （P＜0.05）. Compared with H-pachymic acid group， the aforementioned indicators in pregnant rats from the H-pachymic acid+EX527 group showed significant reversal （P＜0.05）. CONCLUSIONS Pachymic acid significantly ameliorates renal injury induced by PIH in rats， potentially through activation of the Sirt1/PGC-1α pathway.

OBJECTIVE T o carry out the health economics evaluation and cost-benefit analysis of the type b Hae-mophilus influenzae(Hib)vaccination for the children who were hospitalized due to Hib infection so as to provide evidence for public health policies.METHODS The children who were diagnosed with Hib-related respiratory tract infections or meningitis and were hospitalized in respiratory medicine department,infection management depart-ment,emergency rooms and neurology department of Jiangxi Provincial Children's Hospital from Jan.1,2021 to Dec.31,2023 were recruited as the research subjects.Based on a 1∶1 matching condition,the matching variables included four items such as the same age for the admission to the hospital,same gender,same department and same grade of disease severity.The children for whom the primary immunization of Hib vaccination(including Hib monovalent vaccine and Hib-containing combination vaccine)were completed and the integrity of vaccination infor-mation could be checked out were assigned as the intervention group,while the children for whom the primary im-munization of Hib vaccination was not completed were chosen as the control group.The clinical data,vaccination data and the data such as length of hospital stay and hospitalization cost were collected from the children.The cost-benefit of the Hib vaccination among the children with Hib infection was observed.RESULTS A total of 622 hospi-talized children who were detected with Hib-positive respiratory tract infections or meningitis were enrolled in the study,and 73 children(20 children from infection management department,27 children from respiratory medi-cine department,26 children from emergency rooms)were finally included in the intervention group after matc-hing and multiple rounds of screening,73 children were chosen as the control group based on a 1∶1 matching con-dition.The male children accounted for 57.53％(42 cases)in both groups,and the female children accounted for 42.47％(31 cases)in both groups.With the respect to the length of hospital stay,it was 7.00(5.00,8.00)days in the intervention group,7.00(6.00,8.00)days in the control group(Z=-0.341,P=0.733).In terms of the hospitalization cost,it was 7 756.17(6 617.92,10 617.69)yuan in the intervention group,9 040.65(8 033.76,10 935.84)yuan in the control group(Z=-2.795,P=0.005).The cost of Hib vaccination was 343.03 yuan per capita in the intervention group,and the benefit-cost ratio(BCR)was 1∶3.74(343.03 yuan/1 284.48 yuan).CONCLUSIONS The Hib vaccination can save the hospitalization cost and has high cost effectiveness.It is sugges-ted that the Hib vaccination should be promoted and the coverage rate of Hib vaccination should be raised among the age-eligible children.

Objective:To identify tumor-infiltrating immune cells that affect the prognosis of endometrial cancer(EC)with no specific molecular profile(NSMP)subtypeand to establish an integrated prognostic model based on immune cells.Methods:Gene expression data,whole exome sequencing data,and corresponding clinical infor-mation for EC patients were obtained from the The Cancer Genome Atlas(TCGA)database.The CIBERSORTx algorithm was used to evaluate the infiltration levels of 22 types of immune cells in the tumor microenvironment.Kaplan-Meier survival analysis,along with univariate and multivariate Cox regression analyses were used to identi-fy immune cells with prognostic values.A prognostic nomogram was subsequently developed based on significant immune cells and clinicopathological parameters.Results:A total of 169 EC patients classified as NSMP subtype-swere included in this study.Among them 123 patients(72.8％)were aged＜70 years,and 152 patients(89.9％)had type Ⅰ tumors.Kaplan-Meier curves showed that the proportion of plasma cells(P＜0.001),M1 macrophages(P=0.038)and activated NK cells(P=0.01)were significantly associated with overall survival.Multivariate Cox regression analysis revealed that the proportion of activated NK cells(proportion ≥0.027:HR 0.23,95％CI 0.08-0.66,P=0.006),age(≥70 years:HR4.59,95％CI 1.80-11.70,P=0.001)and tumor stage(stage Ⅱ:HR3.87,95％CI 1.18-12.70,P=0.026;stage Ⅲ:HR 6.08,95％CI 1.69-21.87,P=0.006;Ⅳ stage:HR 10.81,95％CI 3.07-38.08,P＜0.001)are independent prognostic indicators for NSMP tumors.A nomogram model was estab-lished by combining activation of NK cells,tumor stage and patient age.Internal cross-validation showed that the integrated prognostic model exhibited good predictive ability for the overall survival rates of patients(P＜0.001).Conclusions:Elevated tumor-infiltrating activated NK cells serve as an independent prognostic indicator for NSMP-subtype EC patients.When integrated with tumor stage and age,they form a robust multivariable prognos-tic model with superior predictive power.

Over the past decade, the field of bone tumor pathology in China has made remarkable progress. These achievements are reflected not only in the innovation and standardization of diagnostic techniques, which have significantly improved diagnostic accuracy, but also in the in-depth exploration of tumor pathogenesis and the continuous refinement of treatment protocols. More than one hundred research papers on bone tumor pathology published in the Chinese Journal of Pathology stand as a testament to the relentless efforts and practical contributions of Chinese pathologists in this field. On the occasion of the Chinese Journal of Pathology′s 70th anniversary, we summarize the progress in bone tumor pathology while also looking forward to the future, aiming to promote greater advancements in this field.

Objective:To identify tumor-infiltrating immune cells that affect the prognosis of endometrial cancer(EC)with no specific molecular profile(NSMP)subtypeand to establish an integrated prognostic model based on immune cells.Methods:Gene expression data,whole exome sequencing data,and corresponding clinical infor-mation for EC patients were obtained from the The Cancer Genome Atlas(TCGA)database.The CIBERSORTx algorithm was used to evaluate the infiltration levels of 22 types of immune cells in the tumor microenvironment.Kaplan-Meier survival analysis,along with univariate and multivariate Cox regression analyses were used to identi-fy immune cells with prognostic values.A prognostic nomogram was subsequently developed based on significant immune cells and clinicopathological parameters.Results:A total of 169 EC patients classified as NSMP subtype-swere included in this study.Among them 123 patients(72.8％)were aged＜70 years,and 152 patients(89.9％)had type Ⅰ tumors.Kaplan-Meier curves showed that the proportion of plasma cells(P＜0.001),M1 macrophages(P=0.038)and activated NK cells(P=0.01)were significantly associated with overall survival.Multivariate Cox regression analysis revealed that the proportion of activated NK cells(proportion ≥0.027:HR 0.23,95％CI 0.08-0.66,P=0.006),age(≥70 years:HR4.59,95％CI 1.80-11.70,P=0.001)and tumor stage(stage Ⅱ:HR3.87,95％CI 1.18-12.70,P=0.026;stage Ⅲ:HR 6.08,95％CI 1.69-21.87,P=0.006;Ⅳ stage:HR 10.81,95％CI 3.07-38.08,P＜0.001)are independent prognostic indicators for NSMP tumors.A nomogram model was estab-lished by combining activation of NK cells,tumor stage and patient age.Internal cross-validation showed that the integrated prognostic model exhibited good predictive ability for the overall survival rates of patients(P＜0.001).Conclusions:Elevated tumor-infiltrating activated NK cells serve as an independent prognostic indicator for NSMP-subtype EC patients.When integrated with tumor stage and age,they form a robust multivariable prognos-tic model with superior predictive power.

OBJECTIVE T o carry out the health economics evaluation and cost-benefit analysis of the type b Hae-mophilus influenzae(Hib)vaccination for the children who were hospitalized due to Hib infection so as to provide evidence for public health policies.METHODS The children who were diagnosed with Hib-related respiratory tract infections or meningitis and were hospitalized in respiratory medicine department,infection management depart-ment,emergency rooms and neurology department of Jiangxi Provincial Children's Hospital from Jan.1,2021 to Dec.31,2023 were recruited as the research subjects.Based on a 1∶1 matching condition,the matching variables included four items such as the same age for the admission to the hospital,same gender,same department and same grade of disease severity.The children for whom the primary immunization of Hib vaccination(including Hib monovalent vaccine and Hib-containing combination vaccine)were completed and the integrity of vaccination infor-mation could be checked out were assigned as the intervention group,while the children for whom the primary im-munization of Hib vaccination was not completed were chosen as the control group.The clinical data,vaccination data and the data such as length of hospital stay and hospitalization cost were collected from the children.The cost-benefit of the Hib vaccination among the children with Hib infection was observed.RESULTS A total of 622 hospi-talized children who were detected with Hib-positive respiratory tract infections or meningitis were enrolled in the study,and 73 children(20 children from infection management department,27 children from respiratory medi-cine department,26 children from emergency rooms)were finally included in the intervention group after matc-hing and multiple rounds of screening,73 children were chosen as the control group based on a 1∶1 matching con-dition.The male children accounted for 57.53％(42 cases)in both groups,and the female children accounted for 42.47％(31 cases)in both groups.With the respect to the length of hospital stay,it was 7.00(5.00,8.00)days in the intervention group,7.00(6.00,8.00)days in the control group(Z=-0.341,P=0.733).In terms of the hospitalization cost,it was 7 756.17(6 617.92,10 617.69)yuan in the intervention group,9 040.65(8 033.76,10 935.84)yuan in the control group(Z=-2.795,P=0.005).The cost of Hib vaccination was 343.03 yuan per capita in the intervention group,and the benefit-cost ratio(BCR)was 1∶3.74(343.03 yuan/1 284.48 yuan).CONCLUSIONS The Hib vaccination can save the hospitalization cost and has high cost effectiveness.It is sugges-ted that the Hib vaccination should be promoted and the coverage rate of Hib vaccination should be raised among the age-eligible children.

Over the past decade, the field of bone tumor pathology in China has made remarkable progress. These achievements are reflected not only in the innovation and standardization of diagnostic techniques, which have significantly improved diagnostic accuracy, but also in the in-depth exploration of tumor pathogenesis and the continuous refinement of treatment protocols. More than one hundred research papers on bone tumor pathology published in the Chinese Journal of Pathology stand as a testament to the relentless efforts and practical contributions of Chinese pathologists in this field. On the occasion of the Chinese Journal of Pathology′s 70th anniversary, we summarize the progress in bone tumor pathology while also looking forward to the future, aiming to promote greater advancements in this field.

Hepatic stellate cell(HSC)activation is a key link in the development of liver fibrosis.The metabolic reprogramming of activated HSC has become a hot topic in current research,especially the change of glycolysis is an important factor in regulating HSC activation.Based on the metabolic reprogramming in the process of HSC activation,this paper expounds the mechanism of regulating HSC activation and liver fibrosis through glycolysis,and reviews the research progress of traditional Chinese medicine and its active ingredients in regulating HSC glycolysis to prevent and treat liver fibrosis.Liver fibrosis is a complex pathological process involving multiple factors and pathways.From the perspective of regulating the glycolysis of activated HSC,it can provide a new idea for the development of anti-liver fibrosis drugs.

Objective To investigate the clinical utility of ultrasound parameters in diagnosing neonatal annular pancreas.Methods A total of 56 neonates with descending duodenal obstruction underwent saline-contrast ultrasound examination.Ultrasonic parameters,including dilated duodenum diameter(DDD),dilated duodenum thickness(DDT),and stenosis duodenum diameter(SDD),were measured.The cases were categorized into three groups:annular pancreas(group A,n=28),descending duodenal atresia(group B,n=3),and descending duodenal septum(group C,n=25).One-way ANOVA was employed to compare statistical differences among the three ultrasonic parameters across the groups,followed by LSD-t test for pairwise comparisons between two groups showing significant differences.Receiver operating characteristics analysis was conducted to calculate the area under the curve and determine the cut-off value if there were statistically significant differences observed.Results In group A,group B,group C,the diameters of DDD were measured as(23.2±2.4)mm,(25±1.0)mm,(19.4±2.6)mm,respectively.When comparing these three groups,there was a statistically significant difference between group A or group B and group C in terms of DDD diameter measurements(t=5.7,P＜0.05;t=3.793,P＜0.05).However,no statistically significant difference was observed between group A and group B for DDD diameter measurements(t=1.232,P＞0.05).The corresponding values for DDT were measured as(3.0±0.6)mm,(3.2±0.4)mm,and(2.4±0.3)mm,respectively.When comparing these three groups,the results showed a statistically significant differ-ence between either Group A or Group B compared to Group C in terms of DDT measurement(t=4.695,P＜0.05;t=2.778,P＜0.05).However,no statistically significant difference was found between Group A and Group B regard-ing the measurement of DDT(t=0.666,P＞0.05).The SDD measurements in the three groups were(1.9±0.3)mm,(3.6±0.8)mm,(5.5±0.7)mm,respectively.Statistical analysis using LSD-t test revealed significant differences between the three groups(t=5.521,P＜0.05;t=6.142,P＜0.05;t=25.828,P＜0.05).The sensitivity,specificity,positive predictive value,and negative predictive value for detecting annular pancreas at a cutoff of 2.3 mm were determined to be 96.4%,100%,100%,and 96.6%,respectively,with an area under the receiver operating charac-teristic curve of 0.999.Conclusion SDD could be employed for the diagnosis of neonatal annular pancreas.

Objective To investigate the effect of self-prescribed Paizhuo Qinggong Herbal Formula Granule combined with Misoprostol Tablets on uterine recovery in patients with residual intrauterine tissue after childbirth. Methods A total of 120 patients with residual intrauterine tissue after childbirth were randomly selected. According to the simple randomization method, 60 patients were assigned to control group(n=60) and experimental group(n=60). In the control group, patients were treated with a placebo of traditional Chinese medicine formula granules combined with Misoprostol Tablets. In the experimental group, patients were treated with self-prescribed Paizhuo Qinggong Herbal Formula Granule combined with Misoprostol Tablets. The clinical efficacy, syndrome score of traditional Chinese medicine, residual area of intrauterine tissue, uterine recovery indicators (sum of three uterine diameters and rate of uterine fundus descent), ultrasound blood flow parameters, matrix alloproteinase-9 (MMP-9), tissue inhibitor of metalloproteinase-1 (TIMP-1), vaginal bleeding, adverse reactions, and uterine curettage rate were analyzed. Results The total effective rate of treatment in the experimental group was higher than that in the control group (P < 0.05). After 1 week and 2 weeks of treatment, there were statistically significant differences in the syndrome score of traditional Chinese medicine and residual area of intrauterine tissue compared with those before treatment (P < 0.05). The syndrome score of traditional Chinese medicine and residual area of intrauterine tissue in the experimental group were lower than those in the control group after 1 week and 2 weeks of treatment (P < 0.05). There were statistically significant differences in the sum of three uterine diameters between the two groups after 1 week and 2 weeks of treatment compared with those before treatment (P < 0.05). The sum of three uterine diameters in the experimental group was lower than that in the control group after 1 week and 2 weeks of treatment (P < 0.05). The rate of uterine fundus descent in the experimental group was higher than that in the control group (P < 0.05). There were statistically significant differences in the resistance index (RI), end-diastolic peak blood flow velocity (EDV), peak systolic blood flow velocity (PSV), and pulsatility index (PI) of the uterine spiral artery between the two groups after 1 week and 2 weeks of treatment compared with those before treatment (P < 0.05). The EDV and PSV in the experimental group were lower than those in the control group after 1 week and 2 weeks of treatment, while the RI and PI were higher (P < 0.05). There were statistically significant differences in the serum levels of matrix metalloproteinase-9(MMP-9) and tissue inhibitor of metalloproteinase-1(TIMP-1) between the two groups after 1 week and 2 weeks of treatment compared with those before treatment (P < 0.05). The serum levels of MMP-9 and TIMP-1 in the experimental group were lower than those in the control group after 1 week and 2 weeks of treatment (P < 0.05). The duration of vaginal bleeding in the experimental group was shorter than that in the control group, and the amount of vaginal bleeding was better in the experimental group (P < 0.05). The uterine curettage rate in the experimental group was lower than that in the control group (P < 0.05). Conclusion The combination of self-prescribed Paizhuo Qinggong Herbal Formula Granule combined with Misoprostol Tablets is effective and safe in the treatment of patients with residual intrauterine tissue after childbirth. It can improve clinical symptoms, uterine blood circulation, reduce the residual area of intrauterine tissue, promote uterine recovery, improve vaginal bleeding, reduce the rate of uterine curettage, and exert its effect by correcting the imbalance of MMP-9 and TIMP-1.