OBJECTIVE To investigate the effects and mechanisms of Buyang huanwu decoction （BYHWD） and its active fractions in ameliorating non-alcoholic fatty liver disease. METHODS BYHWD and its effective fractions obtained through ethanol precipitation， as well as 30% ethanol， 50% ethanol， and 75% ethanol fractions （namely， the CC effective fraction， 30YC effective fraction， 50YC effective fraction， and 75YC effective fraction）， were prepared. These preparations were administered to rats via intragastric administration to prepare corresponding drug-containing serum （blank serum and simvastatin-containing serum were prepared using the same protocol）. Human L02 hepatocytes were divided into control group， model group， simvastatin-containing serum group， BYHWD-containing serum group， CC-containing serum group， 30YC-containing serum group， 50YC-containing serum group， and 75YC-containing serum group. Except for the control group， other groups were given 0.2 mol/L oleic acid for 24 h to induce a lipid accumulation model， and then intervened with 20% drug-containing serum/blank serum for 24 h. The lipid deposition in cells was observed， and the proportion of lipid droplet area was calculated； the levels of triglycerides （TG） and indicators of oxidative stress [malondialdehyde （MDA）， superoxide dismutase （SOD）] as well as liver function [alanine amino- transferase （ALT）， aspartate amino-transferase （AST）] in cells were detected； protein and mRNA expressions of AMP-activated protein kinase （AMPK）/sterol regulatory element-binding protein-1 （SREBP-1）/glycerol-3-phosphate acyltransferase （GPAT） signaling pathway were also measured. RESULTS Compared with the control group， cells in the model group exhibited severe cellular steatosis， with a significantly increased proportion of lipid droplet area， as well as the elevated levels of TG， ALT， AST， and MDA in cells， along with significantly up-regulated mRNA and protein expression levels of SREBP-1 and GPAT （P＜0.05）. The level of SOD， mRNA expression of AMPK， as well as the protein phosphorylation level of AMPK were decreased significantly （P＜0.05）. Compared with the model group， cellular steatosis was alleviated in all drug-containing serum groups， and the levels of most of the aforementioned quantitative indicators were significantly reversed （P＜0.05）. CONCLUSIONS BYHWD and its active fractions can exert a therapeutic effect on improving non-alcoholic fatty liver disease by regulating the AMPK/SREBP-1/GPAT signaling pathway， inhibiting oxidative stress responses， and reducing lipid deposition.

Objective:To analyze the clinicopathological data of invasive stratified mucinous carcinoma(ISMC)of the cervix,thereby providing comprehensive insights for the diagnosis,treatment,and prognosis of this disease.Methods:A retrospective analysis was conducted on 23 cases of ISMC admitted to the Department of Gynecolo-gy at Wuhan University People's Hospital and the Department of Obstetrics and Gynecology at the Second Affilia-ted Hospital of Fujian Medical University between January 2020 and December 2023.The study examined clinical characteristics,pathological features,immunohistochemical results,and prognostic outcomes.Additionally,we compared the prognostic data of 14 cases of cervical gastric adenocarcinoma and 19 cases of cervical neuroendo-crine carcinoma.Results:A total of 23 patients diagnosed with ISMC ranged in age from 27 to 61 years,with 11(47.83％)being postmenopausal.Only one patient exhibited lesions upon physical examination,while the remai-ning patients presented with varying degrees of vaginal bleeding,sometimes accompanied by abnormal vaginal discharge and other symptoms.Among these patients,three were HPV-negative,while the remainder tested posi-tive for HPV,with types 16 and 18 being the most prevalent.Of the 23 patients,15 had isolated ISMC,five had in-vasive cervical adenocarcinoma with partial ISMC involvement,and three had cervical adenosquamous carcinoma with partial ISMC involvement.ISMC patients tested positive(100.00％)for p16 and CK7,with positivity rates of 26.09％for p16 and 9.52％for CK7.Immunohistochemical analysis of p53 was conducted in 15 ISMC patients,re-vealing that 80.00％(12/15)had wild-type p53,while 20.00％had mutant p53.The proportion of patients with a Ki-67 proliferation index above 60％was 77.27％(17/22).The mean follow-up period for the 15 patients with isola-ted ISMC was 10.0 months(1.0-36.0 months),with a recurrence rate of 20.00％and a mortality rate of 6.67％.For the 14 patients with combined diagnoses,the mean follow-up period was 9.5 months(1.0-35.0 months),with a recurrence rate of 50.00％and a mortality rate of 7.14％.In the case of 19 patients with cervical neuroen-docrine carcinoma,the mean follow-up period was 15.0 months(1.0-33.0 months),with a recurrence rate of 31.58％and a mortality rate of 10.52％.However,no statistically significant differences were observed in the recur-rence or mortality rates between cervical neuroendocrine carcinoma and isolated ISMC(P＞0.05).Conclusions:The primary clinical manifestation of ISMC is characterized by vaginal bleeding or abnormal fluid discharge,which demonstrates a strong association with HPV infection.Notably,ISMC lacks specific tumor markers for diagnosis.However,immunohistochemical analysis reveals distinctive molecular expression patterns that may serve as effec-tive diagnostic indicators.It is important to emphasize that ISMC exhibits comparable recurrence and mortality rates to those observed in cervical gastric adenocarcinoma and cervical neuroendocrine carcinoma,underscoring its aggressive clinical behavior.

Objective:To explore the surgical efficacy of cervical cerclage with cervical length (CL) <10 mm and emergency cerclage.Methods:From January 2013 to June 2022, a total of 98 singleton pregnant women who underwent ultrasound-indicated cervical cerclage because of CL<10 mm in the second trimester and underwent emergency cervical cerclage because of cervical dilation found by physical examination in Peking University First Hospital were enrolled. The differences in clinical data between the <34 weeks delivery group (25 cases) and the ≥34 weeks delivery group (73 cases) were compared. Meanwhile, according to different cervical status, they were divided into CL<10 mm group (43 cases) and cervical dilatation group (55 cases), and the cervical dilatation group was further divided into cervical dilatation <4 cm group and cervical dilatation ≥4 cm group. The clinical data and pregnancy outcomes of pregnant women with different cervical status were compared.Results:(1) There were significant differences in the proportion of preoperative CL<10 mm and the degree of preoperative cervical dilation between the <34 weeks delivery group and the ≥34 weeks delivery group (all P<0.05). (2) After cervical cerclage, compared with women in the cervical dilatation group, the prolonged gestational age in the CL<10 mm group was longer [(10.5±4.6) vs (14.3±3.4) weeks], the gestational age at delivery was later (median: 35.7 vs 38.0 weeks), the preterm birth rates before 37 and 34 weeks were lower, the late abortion rate was lower [9% (5/55) vs 0 (0/43)], and the newborn birth weight was higher, the differences were statistically significant (all P<0.05). (3) Compared with the cervical dilation ≥4 cm group, the prolonged gestational age of the cervical dilatation <4 cm group was longer [(7.5±5.3) vs (11.1±4.2) weeks], the gestational age at delivery was later (median: 29.2 vs 36.0 weeks), and the birth weight of the newborn was higher (all P<0.05). The late abortion rate of cervical dilatation <4 cm group was lower than that of cervical dilatation ≥4 cm group [7% (3/45) vs 2/10; P=0.220]. Conclusions:Timely cervical cerclage in individuals with CL<10 mm could reduce preterm birth rate before 34 weeks gestation, and the pregnancy outcome is better than that of individuals with cervical dilation. Moreover, the pregnancy outcome of cervical cerclage in women with cervical dilation <4 cm is significantly better than that in women with cervical dilatation ≥4 cm.

Cholesterol is a crucial lipid in the human body.Elevated levels of cholesterol can result in condi-tions such as hypercholesterolemia.3-hydroxy-3-methylglutaryl coenzyme A reductase(HMGCR)serves as a pivotal en-zyme in the synthesis of cholesterol,acting as a rate-limiting factor.As a result,HMGCR plays a critical role in maintain-ing cholesterol balance,with the regulatory processes being intricate in vivo.This review outlines the advancements in un-derstanding the regulatory mechanisms of HMGCR,encompassing transcriptional control,degradation pathways,and en-zyme activity.

Objective:To explore the surgical efficacy of cervical cerclage with cervical length (CL) <10 mm and emergency cerclage.Methods:From January 2013 to June 2022, a total of 98 singleton pregnant women who underwent ultrasound-indicated cervical cerclage because of CL<10 mm in the second trimester and underwent emergency cervical cerclage because of cervical dilation found by physical examination in Peking University First Hospital were enrolled. The differences in clinical data between the <34 weeks delivery group (25 cases) and the ≥34 weeks delivery group (73 cases) were compared. Meanwhile, according to different cervical status, they were divided into CL<10 mm group (43 cases) and cervical dilatation group (55 cases), and the cervical dilatation group was further divided into cervical dilatation <4 cm group and cervical dilatation ≥4 cm group. The clinical data and pregnancy outcomes of pregnant women with different cervical status were compared.Results:(1) There were significant differences in the proportion of preoperative CL<10 mm and the degree of preoperative cervical dilation between the <34 weeks delivery group and the ≥34 weeks delivery group (all P<0.05). (2) After cervical cerclage, compared with women in the cervical dilatation group, the prolonged gestational age in the CL<10 mm group was longer [(10.5±4.6) vs (14.3±3.4) weeks], the gestational age at delivery was later (median: 35.7 vs 38.0 weeks), the preterm birth rates before 37 and 34 weeks were lower, the late abortion rate was lower [9% (5/55) vs 0 (0/43)], and the newborn birth weight was higher, the differences were statistically significant (all P<0.05). (3) Compared with the cervical dilation ≥4 cm group, the prolonged gestational age of the cervical dilatation <4 cm group was longer [(7.5±5.3) vs (11.1±4.2) weeks], the gestational age at delivery was later (median: 29.2 vs 36.0 weeks), and the birth weight of the newborn was higher (all P<0.05). The late abortion rate of cervical dilatation <4 cm group was lower than that of cervical dilatation ≥4 cm group [7% (3/45) vs 2/10; P=0.220]. Conclusions:Timely cervical cerclage in individuals with CL<10 mm could reduce preterm birth rate before 34 weeks gestation, and the pregnancy outcome is better than that of individuals with cervical dilation. Moreover, the pregnancy outcome of cervical cerclage in women with cervical dilation <4 cm is significantly better than that in women with cervical dilatation ≥4 cm.

Objective:To analyze the clinicopathological data of invasive stratified mucinous carcinoma(ISMC)of the cervix,thereby providing comprehensive insights for the diagnosis,treatment,and prognosis of this disease.Methods:A retrospective analysis was conducted on 23 cases of ISMC admitted to the Department of Gynecolo-gy at Wuhan University People's Hospital and the Department of Obstetrics and Gynecology at the Second Affilia-ted Hospital of Fujian Medical University between January 2020 and December 2023.The study examined clinical characteristics,pathological features,immunohistochemical results,and prognostic outcomes.Additionally,we compared the prognostic data of 14 cases of cervical gastric adenocarcinoma and 19 cases of cervical neuroendo-crine carcinoma.Results:A total of 23 patients diagnosed with ISMC ranged in age from 27 to 61 years,with 11(47.83％)being postmenopausal.Only one patient exhibited lesions upon physical examination,while the remai-ning patients presented with varying degrees of vaginal bleeding,sometimes accompanied by abnormal vaginal discharge and other symptoms.Among these patients,three were HPV-negative,while the remainder tested posi-tive for HPV,with types 16 and 18 being the most prevalent.Of the 23 patients,15 had isolated ISMC,five had in-vasive cervical adenocarcinoma with partial ISMC involvement,and three had cervical adenosquamous carcinoma with partial ISMC involvement.ISMC patients tested positive(100.00％)for p16 and CK7,with positivity rates of 26.09％for p16 and 9.52％for CK7.Immunohistochemical analysis of p53 was conducted in 15 ISMC patients,re-vealing that 80.00％(12/15)had wild-type p53,while 20.00％had mutant p53.The proportion of patients with a Ki-67 proliferation index above 60％was 77.27％(17/22).The mean follow-up period for the 15 patients with isola-ted ISMC was 10.0 months(1.0-36.0 months),with a recurrence rate of 20.00％and a mortality rate of 6.67％.For the 14 patients with combined diagnoses,the mean follow-up period was 9.5 months(1.0-35.0 months),with a recurrence rate of 50.00％and a mortality rate of 7.14％.In the case of 19 patients with cervical neuroen-docrine carcinoma,the mean follow-up period was 15.0 months(1.0-33.0 months),with a recurrence rate of 31.58％and a mortality rate of 10.52％.However,no statistically significant differences were observed in the recur-rence or mortality rates between cervical neuroendocrine carcinoma and isolated ISMC(P＞0.05).Conclusions:The primary clinical manifestation of ISMC is characterized by vaginal bleeding or abnormal fluid discharge,which demonstrates a strong association with HPV infection.Notably,ISMC lacks specific tumor markers for diagnosis.However,immunohistochemical analysis reveals distinctive molecular expression patterns that may serve as effec-tive diagnostic indicators.It is important to emphasize that ISMC exhibits comparable recurrence and mortality rates to those observed in cervical gastric adenocarcinoma and cervical neuroendocrine carcinoma,underscoring its aggressive clinical behavior.

Objective:To analyze the effect of joint management of type 2 diabetes mellitus (T2DM) between specialty and community under the model of National Diabetes Prevention and Control Center (DPCC).Methods:A total of 2 527 T2DM patients managed by DPCC Pingshan Center of Shenzhen from January 1, 2022 to December 31, 2024 were retrospectively included. After management, the rate of downturn, reexamination rate, blood pressure compliance rate, metabolic indicators (waist circumference, body mass index, fasting blood glucose, glycosylated hemoglobin, blood lipids) and screening rate of chronic complications of diabetes (atherosclerotic cardiovascular disease, microvascular disease, diabetic peripheral neuropathy) were analyzed. Those included 2022 ( n=564), 2023 ( n=1 477), and 2024 ( n=2 527). Results:The downturn rate in 2022, 2023 and 2024 increased year by year (22.8% vs 67.2% vs 89.9%, P<0.01), and the review rate (41.1% vs 62.2% vs 52.7%, P<0.01), complication screening rate (51.6% vs 85.3% vs 62.2%, P<0.01), blood pressure compliance rate (53.1% vs 78.0% vs 67.2%, P<0.01), body mass index compliance rate (13.2% vs 17.3% vs 28.6%, P<0.01), fasting blood glucose meeting rate (46.4% vs 60.2% vs 68.5%, P<0.01), glycated hemoglobin meeting rate (58.4% vs 63.2% vs 45.6%, P<0.01) were relatively improved. Waist circumference compliance rate (30.6% vs 27.7% vs 21.6%) and blood lipid compliance rate (33.6% vs 35.5% vs 31.9%) were not significantly improved, and the review rate, blood pressure compliance rate and complication screening rate in 2024 were lower than those in 2023 and higher than those in 2022. Conclusions:The combined management of type 2 diabetes under the DPCC model has significant effects on improving the down-conversion rate, rediagnosis rate, blood pressure compliance rate, metabolic index compliance rate and the screening rate of diabetes-related chronic complications in patients with diabetes. At the same time, it was also found that with the progress of hierarchical diagnosis and treatment, the review rate, complication screening rate, blood pressure, waist circumference, blood lipid and glycosylated hemoglobin reached the standard of patients decreased compared with the previous situation, which needs to be further analyzed and improved.

Objective:To analyze the effect of joint management of type 2 diabetes mellitus (T2DM) between specialty and community under the model of National Diabetes Prevention and Control Center (DPCC).Methods:A total of 2 527 T2DM patients managed by DPCC Pingshan Center of Shenzhen from January 1, 2022 to December 31, 2024 were retrospectively included. After management, the rate of downturn, reexamination rate, blood pressure compliance rate, metabolic indicators (waist circumference, body mass index, fasting blood glucose, glycosylated hemoglobin, blood lipids) and screening rate of chronic complications of diabetes (atherosclerotic cardiovascular disease, microvascular disease, diabetic peripheral neuropathy) were analyzed. Those included 2022 ( n=564), 2023 ( n=1 477), and 2024 ( n=2 527). Results:The downturn rate in 2022, 2023 and 2024 increased year by year (22.8% vs 67.2% vs 89.9%, P<0.01), and the review rate (41.1% vs 62.2% vs 52.7%, P<0.01), complication screening rate (51.6% vs 85.3% vs 62.2%, P<0.01), blood pressure compliance rate (53.1% vs 78.0% vs 67.2%, P<0.01), body mass index compliance rate (13.2% vs 17.3% vs 28.6%, P<0.01), fasting blood glucose meeting rate (46.4% vs 60.2% vs 68.5%, P<0.01), glycated hemoglobin meeting rate (58.4% vs 63.2% vs 45.6%, P<0.01) were relatively improved. Waist circumference compliance rate (30.6% vs 27.7% vs 21.6%) and blood lipid compliance rate (33.6% vs 35.5% vs 31.9%) were not significantly improved, and the review rate, blood pressure compliance rate and complication screening rate in 2024 were lower than those in 2023 and higher than those in 2022. Conclusions:The combined management of type 2 diabetes under the DPCC model has significant effects on improving the down-conversion rate, rediagnosis rate, blood pressure compliance rate, metabolic index compliance rate and the screening rate of diabetes-related chronic complications in patients with diabetes. At the same time, it was also found that with the progress of hierarchical diagnosis and treatment, the review rate, complication screening rate, blood pressure, waist circumference, blood lipid and glycosylated hemoglobin reached the standard of patients decreased compared with the previous situation, which needs to be further analyzed and improved.

Cholesterol is a crucial lipid in the human body.Elevated levels of cholesterol can result in condi-tions such as hypercholesterolemia.3-hydroxy-3-methylglutaryl coenzyme A reductase(HMGCR)serves as a pivotal en-zyme in the synthesis of cholesterol,acting as a rate-limiting factor.As a result,HMGCR plays a critical role in maintain-ing cholesterol balance,with the regulatory processes being intricate in vivo.This review outlines the advancements in un-derstanding the regulatory mechanisms of HMGCR,encompassing transcriptional control,degradation pathways,and en-zyme activity.

Objective We aimed to investigate the relationship between microscopic pattern of blood stasis and renal pathological grade and related physical and chemical indexes in children with Henoch-Sch?nlein purpura nephritis(HSPN).Methods We conducted a retrospective analysis of 800 HSPN children from the medical records of the First Affiliated Hospital of Henan University of Chinese Medicine.Laboratory indicators(blood routine test,urine routine test,coagulation test,liver function)and renal pathological indicators of them were collected.According to the severity of renal pathological microscopic lesions,the microscopic pattern of blood stasis was divided into three types,including choroidal discord,dead blood coagulation and intracarenal disease accumulation.The classification of renal microscopic pattern of blood stasis and the correlation between laboratory indexes and renal pathological index were analyzed by Spearman grade correlation and binary Logistic regression analysis.Results(ⅰ)There was no statistical difference of the distribution of the renal microscopic pattern of blood stasis in the different traditional Chinese medicine patterns.(ⅱ)There were significant differences in the contents or the grade of albumin and fibrinogen in the HSPN children with different microscopic pattern of blood stasis(all P＜0.05).(ⅲ)The maximum area under the receiver operating characteristic(ROC)curve between fibrinogen and intracarenal disease accumulation was 0.594(95％CI from 0.540 to 0.633,P＜0.001);sensitivity was 0.447,specificity was 0.725;the best threshold on the ROC curve of 0.172 was 3.755 g/L.(ⅳ)There were positive correlations between the content of fibrinogen,ISKDC grade and Bohle A grade respectively with the scores of intracarenal disease accumulation type(r=0.176,r=0.315,r=0.656;all P＜0.001).(ⅴ)There were positive correlations between the content of fibrinogen,ISKDC grade and Bohle A grade respectively with the renal microscopic pattern of blood stasis(r=0.157,r=0.377,r=0.429;all P＜0.001).Conclusion The microscopic renal pattern of blood stasis can not only reflect the severity of renal blood stasis,but also reflect the severity and long-term prognosis of renal diseases.Albumin and urinary protein grade can reflect the early stage of the microscopic renal pattern of the blood stasis(choroidal discord).The content of fibrinogen increases with the aggravation of renal microscopic pattern of blood stasis,reflecting the end-stage of HSPN,which has the correlation with the formation and severity of related indexes.Fibrinogen can be used as a laboratory indicator to assist in the diagnosis of irreversible lesionsin the renal pathology of HSPN children.