Mucosa-associated lymphoid tissue (MALT) lymphoma is an indolent B cell derived non-Hodgkin's lymphoma. It is the main type of uveal lymphoma and is extremely rare. The pathogenesis of ocular MALT lymphoma remains unclear. It is now considered to be associated with many causes. The manifestations of primary uveal MALT lymphoma differ. So sometimes it is necessary to diagnose depending on diversity of auxiliary tests. Ultrasound examination shows typical low and homogeneous internal reflectivity, with blood flow signal. Optical coherence tomography, fundus imaging, fundus angiography, magnetic resonance imaging and positron emission tomography computerized tomography can assist diagnosing. Primary uveal MALT lymphoma is sensitive to radiation therapy, chemotherapy and biotherapy have positive influence too. The prognosis of uveal MALT lymphoma is good, but its early diagnosis is rather challenging. The nonspecific clinical manifestations and the rarity of the disease can confound the initial diagnosis, resulting in delayed treatments which may cause irreversible vision loss.

Advances in imaging technology have revolutionized the field of ophthalmology, changing the understanding, diagnosis, and treatment of ophthalmic diseases. Swept-source optical coherence tomography(SS-OCT)is a non-contact high-resolution imaging technology. It further improves imaging depth and scanning speed, adds new algorithms and features. The application of SS-OCT enables the three-dimensional evaluation of corneal structures, offering curvature and height maps for both the anterior and posterior surfaces of the cornea, as well as precise corneal thickness mapping. These invaluable tools aid ophthalmologists in effectively screening and diagnosing various corneal lesions such as keratoconus, corneal dystrophy, and degeneration. Moreover, the enhanced speed, accuracy, and sensitivity provided by SS-OCT measurements facilitate improved surgical planning and postoperative monitoring for patients undergoing refractive surgery or keratoplasty. This article reviews the development of SS-OCT technology and its potential clinical utility in corneal diseases and surgical application, in order to support more possible future research and clinical treatment.

Objective To assess the effectiveness of combining problem-based learning(PBL),team-based learning(TBL),and clinical pathway(CP)in standardized training of periodontology residents.Methods A total of 48 residents who were transferred to the Department of Periodontology at the Fourth Affiliated Hospital of Harbin Medical University from January to October 2023 were ran-domly assigned to either the traditional teaching group or the PBL,TBL,and CP combined teaching group,with 24 participants in each group.The traditional teaching group followed conventional teaching methods,while the PBL,TBL,and CP combined teaching group utilized a combination of these three methods.Prior to completing their rotation,both groups underwent professional assessments as well as surveys on satisfaction with standardized training and self-evaluation.Results The professional examination scores ofcombined teaching group were significantly higher than those of the traditional teaching method group(P＜0.05).Both groups expressed satisfac-tion with standardized training and demonstrated proficiency in diagnosing and treating periodontitis through instruction;no statistically significant difference was observed between them(P＞0.05).However,compared to the traditional teaching group,students in the PBL,TBL,and CP combined teaching group showed significant improvements in doctor-patient communication skills,active informa-tion retrieval abilities,learning interest levels,team discussions,and clinical logical thinking abilities(P＜0.05).Conclusion Im-plementing a combination of PBL,TBL,and CP during standardized training of periodontology residents can enhance students'profes-sional examination scores and self-evaluation results,which promotes educational reform development by providing an objective basis.

Type 2 diabetes mellitus （T2DM） is a chronic metabolic disease characterized by insulin resistance， hyperinsulinemia， and disturbance of glucose and lipid metabolism， with elevated blood glucose as the main clinical manifestation. Due to its complex etiology and pathogenesis， there is no effective treatment， which critically threatens human health and places a heavy burden on society and families. Saponins are a class of glycosides with complex structures that have the advantage of a wide range of sources， elevated safety， and low adverse effects. As an essential active ingredient in Chinese medicine， Chinese medicine saponins have a variety of biological activities such as hypoglycemia， hypoglycaemia， anti-inflammation， antioxidation， anti-tumor， and immune modulation. In recent years， numerous studies have shown that Chinese medicine saponins are effective in preventing and treating T2DM. Although there have been numerous studies on the hypoglycemic effects and mechanisms of Chinese medicine saponins， there has been no systematic review of the mechanisms of Chinese medicine saponins in the treatment of T2DM. Therefore， to provide a theoretical basis for an in-depth study of the hypoglycemic effects of Chinese medicine saponins and a scientific basis for the development and clinical application of drugs， this paper systematically summarized the hypoglycemic mechanisms of Chinese medicine saponins， such as improving islet β-cell function， improving insulin resistance， inhibiting glycosidase activity， reducing the inflammatory response， anti-oxidative stress， and regulating intestinal flora， and analyzed the current research problems and development trends.

Social isolation represents the development of a certain level, either partial or complete, of deprivation of socialization and may have adverse effects in many aspects for the elderly, which can be physiological, psychological and social.Meanwhile, during the course of human life, aging becomes an inevitable process and brings about changes in cognitive ability, which become an important focus of our attention.This paper reviews the research progress on the relationship between social isolation and cognitive ability in the elderly, in order to provide a new perspective for future research on social isolation and cognitive ability in the elderly and also to offer new insight on how to construct a model of intervention and health management for the elderly population with social isolation.

Objective:To evaluate the role of heat shock transcription factor 1 (HSF1) in the endogenous protective mechanism underlying mechanical ventilator-induced lung injury (VILI) in mice and the relationship with high mobility group box 1 (HMGB1).Methods:Forty SPF healthy male C57BL/6 mice, aged 6-8 weeks, weighing 20-25 g, were divided into 4 groups ( n=10 each) by the random number table method: control group (group C), VILI group (group VILI), negative control siRNA + VILI group (group NV) and HSF1 siRNA + VILI group (group siRNA). At 48 h before mechanical ventilation, negative control siRNA 5 nmol and HSF1 siRNA 5 nmol were intratracheally injected in NV and siRNA groups respectively, and the solution was diluted to 50 μl with the sterile phosphate buffer in both groups. Group C kept spontaneous breathing for 4 h, and the rest animals were mechanically ventilated (tidal volume 35 ml/kg, respiratory rate 75 breaths/min, inspiratory/expiratory ratio 1∶2, fraction of inspired oxygen 21%) for 4 h. Blood samples from the femoral artery were collected for arterial blood gas analysis immediately after endotracheal intubation and at 4 h of ventilation, and PaO 2 was recorded. Then the mice were sacrificed under deep anesthesia to collect lung tissues and bronchoalveolar lavage fluid (BALF). The concentrations of interleukin-1beta (IL-1β), tumor necrosis factor-alpha (TNF-α) and HMGB1 in BALF were determined by enzyme-linked immunosorbent assay. The pathological results were observed by hematoxylin-eosin staining, and lung injury was assessed and scored. The wet/dry (W/D) weight ratio of lung tissues was calculated. The expression of HMGB1 and HSF1 mRNA in lung tissues (by quantitative real-time polymerase chain reaction) and expression of HMGB1 and HSF1 protein in lung tissues (by Western blot) were determined. Results:Compared with group C, PaO 2 was significantly decreased at 4 h of ventilation, the concentrations of TNF-α, IL-1β and HMGB1 in BALF, W/D ratio and lung injury score were increased, and the expression of HMGB1 protein and mRNA in lung tissues was up-regulated in group VILI, group NV and group siRNA ( P<0.05 or 0.01). Compared with group VILI and group NV, PaO 2 was significantly decreased at 4 h of ventilation, the concentrations of TNF-α, IL-1β and HMGB1 in BALF, W/D ratio and lung injury score were increased, and the expression of HMGB1 protein and mRNA in lung tissues was up-regulated, and the expression of HSF1 protein and mRNA was down-regulated in group siRNA ( P<0.05 or 0.01). There was no significant difference in the parameters mentioned above between group VILI and group NV ( P>0.05). Conclusions:HSF1 is involved in the endogenous protective mechanism underlying VILI in mice, which may be related to the down-regulation of HMGB1 expression and attenuation of inflammatory responses in lung tissues.

Objective:To investigate the effects of placenta previa on the surgical and pregnancy outcomes in patients with total/subtotal or segmental hysterectomy attributed to placenta accreta spectrum disorders (PAS).Methods:This study retrospectively enrolled 510 patients who gave birth and underwent total/subtotal hysterectomy or segmental hysterectomy (local implantation site) due to PAS at the third Affiliated Hospital of Guangzhou Medical University from January 1, 2017, to December 31, 2022. These subjects were divided into the placenta previa group (427 cases) and non-placenta previa group (83 cases). According to the type of hysterectomy, they were further divided into the total/subtotal hysterectomy and placenta previa subgroup (221 cases), total/subtotal hysterectomy and non-placenta previa subgroup (23 cases), segmental hysterectomy and placenta previa subgroup (206 cases), and segmental hysterectomy and non-placenta previa subgroup (60 cases). Nonparametric test or Chi-square test were used to compare the differences in the clinical features, surgical and pregnancy outcomes between different groups. Binary logistic regression was used to analyze the effects of placenta previa on the risk of additional surgical procedures and adverse maternal outcomes. Results:(1) Compared with the non-placenta previa group, the hemorrhage volume within 24 h postpartum [1 541 ml (1 036-2 368 ml) vs 1 111 ml (695-2 000 ml), Z=－3.91] and the proportion of women requiring additional surgical procedures [84.8% (362/427) vs 69.9% (58/83), χ2=10.61], with total/subtotal hysterectomy [51.8% (221/427) vs 27.7% (23/83), χ2=16.10], cystoscopy and/or ureteral stenting [60.7% (259/427) vs 31.3% (26/83), χ2=24.25], total adverse pregnancy outcomes [86.9% (371/427) vs 65.1% (54/83), χ2=17.75], hemorrhage volume>1 500 ml within 24 h postpartum [54.1% (231/427) vs 33.7% (28/83), χ2=29.94], transfusion of blood products [75.9% (324/427) vs 47.0% (39/83), χ2=28.27] were all higher in the placenta previa group (all P<0.05). Binary logistic regression analysis found that for PAS patients with hysterectomy, regardless of the hysterectomy type (total/subtotal/segmental), placenta previa was risk factor for requiring additional surgical procedures ( aOR=3.26, 95% CI: 1.85-5.72) and adverse pregnancy outcomes ( aOR=5.59, 95% CI: 2.01-6.42), even if adjusting for the confounding factors such as maternal age, number of previous cesarean sections, parity, gestational weight gain, twin pregnancy, and the use of assisted reproductive technology. (2) In patients with total/subtotal hysterectomy, the proportion of women requiring additional surgical procedures was higher in those with placenta previa [82.8% (183/221) vs 56.5% (13/23), χ2=9.11] than those without placenta previa, especially the proportion of cystoscopy and/or ureteral stenting [67.9% (150/221) vs 34.8% (8/23), χ2=9.99] (both P<0.05). However, no significant difference was found in adverse pregnancy outcomes [89.6% (198/221) vs 87.0% (20/23), χ2<0.01, P=0.972] between the two groups. In patients with segmental hysterectomy, higher proportions of women requiring additional surgery [86.9% (179/206) vs 75.0% (45/60), χ2=4.94], with adverse pregnancy outcomes [84.0% (173/206) vs 56.7% (34/60), χ2=25.31], cystoscopy and/or ureteral stenting [52.9% (109/206) vs 30.0% (18/60), χ2=9.78], vascular occlusion [94.2% (194/206) vs 71.7% (43/60), χ2=24.23], hemorrhage volume>1 500 ml within 24 h postpartum [46.6% (96/206) vs 23.3% (14/60), χ2=10.37], and transfusion of blood products [68.9% (142/206) vs 33.3% (20/60), χ2=24.73] were found in the placenta previa group (all P<0.05). Furthermore, patients with placenta previa had more hemorrhage volume within 24 h postpartum [1 368 ml (970-2 026 ml) vs 995 ml (654-1 352 ml), Z=－3.66, P<0.001] in the segmental hysterectomy subgroup. After adjusting for the confounding factors such as age, number of previous cesarean sections, parity, gestational weight gain, twin pregnancy, and the use of assisted reproductive technology, binary logistic regression analysis found that placenta previa did not increase the risk of additional surgical operations ( aOR=2.71, 95% CI: 0.99-7.42) and adverse pregnancy outcomes ( aOR=2.14, 95% CI: 0.54-8.42) in patients with total/subtotal hysterectomy but were risk factors of the two outcomes for those with segmental hysterectomy ( aOR=4.67, 95% CI: 2.15-10.10; aOR=3.80, 95% CI: 1.86-7.77). Conclusions:Placenta previa increases the risk of additional surgical procedures and adverse pregnancy outcomes in patients with total/subtotal or segmental hysterectomy caused by PAS. Appropriate preparation is required after the clinical diagnosis of PAS with placenta previa.

Objective:To investigate whether the number of previous cesarean sections affects the outcomes of patients with placental implantation disease undergoing hysterectomy.Methods:Using a retrospective cohort study design, the study samples were from the obstetric clinical database of the Third Affiliated Hospital of Guangzhou Medical University, and the study subjects were patients with placental implantation disease who underwent hysterectomy. Patients were grouped according to different previous cesarean section frequencies, and their clinical characteristics, surgical outcomes, and adverse maternal outcomes were compared in each group; The impact of previous cesarean sections on adverse outcomes in pregnant women was analyzed using multivariate logistic regression.Results:Among the 244 enrolled patients, 26 had no previous history of cesarean section (11%), 132 had a previous cesarean section once (54%), and 86 had a previous cesarean section ≥2 times (35%). There was no statistically significant difference in the usage rates of uterine artery embolization, suture hemostasis, and internal iliac artery embolization among the three groups of patients (all P>0.05). Among the adverse outcomes of pregnant and postpartum women, there was no statistically significant difference in the rates of shock, bladder injury, postpartum hemorrhage, postpartum hemorrhage >1 500 ml, admission to the intensive care unit (ICU), and transfusion of blood products among the three groups (all P>0.05). Univariate logistic regression analysis showed that the number of previous cesarean sections did not increase the risk of adverse outcomes, such as shock, postpartum hemorrhage, postpartum hemorrhage ≥1 500 ml, entry into the ICU, and transfusion of blood products. Multivariate logistic regression analysis found that the number of previous cesarean sections did not increase the risk of adverse outcomes in pregnant women. Conclusions:For patients with placental implantation disease undergoing hysterectomy, the number of previous cesarean sections may not be the main factor determining maternal outcomes. It is necessary to consider other possible influencing factors more comprehensively, including previous uterine surgery history, basic health status of pregnant women, comorbidities, and availability of medical resources.

Objective:To evaluate the role of inositol-requiring kinase 1α-X-box binding protein 1 (IRE1α/XBP1) signaling pathway in endoplasmic reticulumin in endotoxin-induced acute lung injury (ALI) in mice and the relationship with NOD-like receptor pyrin domain containing 3 (NLRP3) inflammasomes.Methods:Thirty-six SPF-grade healthy male C57BL/6 mice, aged 6-8 weeks, weighing 25-30 g, were divided into 3 groups ( n=12 each) according to the random number table method: control group (group C), endotoxin-induced ALI group (group ALI) and endotoxin-induced ALI+ STF-083010 group (group ST). The ALI model was established by inhaling nebulized lipopolysaccharide (LPS) 3 mg/ml for 30 min in ALI and ST groups, while the equal volume of nebulized normal saline was given in group C. IRE1α/XBP1 signaling pathway inhibitor STF-083010 50 mg/kg was intraperitoneally injected at 1 h before inhaling LPS in group ST, while the remaining two groups received the equal volume of normal saline intraperitoneally. Mice were sacrificed at 24 h after inhaling nebulized LPS or normal saline, bronchoalveolar lavage fluid (BALF) were collected and lung tissues were removed for microscopic examination of the pathological changes (by HE staining) which were scored and for determination of wet/dry lung weight ratio (W/D ratio), concentrations of interleukin-1beta (IL-lβ) and IL-18 in BALF (by enzyme-linked immunosorbent assay) and expression of phosphorylated IRE1α (p-IRE1α), XBP1s, NLRP3, ASC and caspase-1 in lung tissues (by Western blot). Results:Compared with group C, the W/D ratio, lung injury score and concentrations of IL-1β and IL-18 in BALF were significantly increased, and the expression of p-IRE1α, XBP1s, NLRP3, ASC and caspase-1 in lung tissues was up-regulated in group ALI and group ST ( P<0.001). Compared with group ALI, the W/D ratio, lung injury score and concentrations of IL-1β and IL-18 in BALF were significantly decreased, and the expression of p-IRE1α, XBP1s, NLRP3, ASC and caspase-1 protein in lung tissues was down-regulated in group ST ( P<0.001). Conclusions:IRE1α/XBP1 signaling pathway is involved in LPS-induced ALI in mice, and the mechanism is related to activation of NLRP3 inflammasomes.

ObjectiveTo observe the effects of the water extracts of Trichosanthis Radix-Polygonati Rhizoma at different ratios on glucose and lipid metabolism in KKAy mice with spontaneous type 2 diabetes and explore the mechanism of the extract in alleviating insulin resistance based on phosphatidylinositol 3-kinase （PI3K）/protein kinase B （Akt）/forkhead box O1 （FoxO1） signaling pathway. MethodThe 8-week-old C57BL/6J male mice were taken as the normal control group， and KKAy male mice of the same age were randomly assigned into a model group， a metformin group， Trichosanthis Radix-Polygonati Rhizoma groups at the ratios of 1∶1 （Trichosanthis Radix 30 g， Polygonati Rhizoma 30 g）， 1∶3 （Trichosanthis Radix 15 g， Polygonati Rhizoma 45 g）， and 1∶5 （Trichosanthis Radix 10 g， Polygonati Rhizoma 50 g） according to blood glucose level and body weight， with 6 mice in each group. The administration lasted for 8 weeks， and the body weight （BW） and fasting blood glucose （FBG） of mice were recorded at the same time points of the 2nd， 4th， 6th， and 8th weeks， respectively. Oral glucose tolerance test （OGTT） was performed at the 7th week. After drug administration， the serum levels of total cholesterol （TC）， triglyceride （TG）， low-density lipoprotein cholesterol （LDL-C）， high-density lipoprotein cholesterol （HDL-C）， and fasting insulin （FINS） were measured， and homeostasis model assessment-insulin resistance （HOMA-IR） index was calculated. The liver tissue samples were stained with hematylin-eosin （HE） and periodic acid-Schiff （PAS） for observation of the fat distribution and glycogen content. The protein levels of PI3K， Akt， p-Akt， FoxO1， and p-FoxO1 in the liver were determined by Western blot. ResultCompared with the normal group， the model group showed increased food intake， FBG， glucose tolerance， FINS， HOMA-IR， TC， TG， and LDL-C （P<0.01）， and down-regulated protein levels of PI3K， Akt， phosphorylaison （p）-Akt， FoxO1， and p-FoxO1 in the liver （P<0.01）. Compared with the model group， Trichosanthis Radix-Polygonati Rhizoma lowered FBG and HOMA-IR （P<0.05， P<0.01）. In particular， the combination at the ratio of 1∶3 showed the best performance （P<0.01） comparable to metformin. Furthermore， Trichosanthis Radix-Polygonati Rhizoma at different ratios lowered blood glucose at different time points of OGTT （P<0.05） and TC and LDL-C （P<0.01）. Additionally， the combination at the ratio of 1∶3 reduced TG （P<0.01）. The liver of mice in the drug administration groups showed regular morphology， with few lipid droplets and rich glycogen. Western blot showed that Trichosanthis Radix-Polygonati Rhizoma up-regulated the protein levels of PI3K and p-Akt， down-regulated the protein level of FoxO1， and up-regulated the protein level of p-FoxO1 （P<0.05）. ConclusionTrichosanthis Radix-Polygonati Rhizoma， especially at the ratio of 1∶3， lowered the FBG， TC， LDL-C， and HOMA-IR index， promoted liver glycogen synthesis， and reduced steatosis in KKAy mice， which may be related to the regulation of PI3K/Akt/FoxO1 signaling pathway in the liver.