Objective To observe the effects of electroacupuncture at"Neiguan"and"Gongsun"on autophagy and apoptosis related indexes of interstitial cells of Cajal(ICC)in rats with functional dyspepsia(FD);To explore its possible mechanism on improving gastrointestinal motility of FD.Methods Totally 32 SPF grade SD rats were randomly divided into blank group,model group,electroacupuncture group and Western medicine group,with 8 rats in each group.An FD model was constructed using a composite etiology modeling method.The electroacupuncture group received electroacupuncture at"Neiguan"and"Gongsun",while the Western medicine group received oral administration of mosapride once a day for 7 consecutive days.The general condition,body mass and average daily intake of rats were observed every week,and gastric emptying rate and small intestine propulsion rate were detected,transmission electron microscopy was used to observe the structure of gastric antrum ICC,Western blot was used to observe the expressions of c-kit,Beclin1,LC3Ⅱ/Ⅰ,p62,Caspase-3 protein in gastric antrum tissue,qPCR was used to observe the mRNA expressions of Beclin1,LC3Ⅱ/Ⅰ,p62 and c-kit in gastric antrum tissue,TUNEL staining was used to detect the apoptosis rate of cells in gastric antrum tissue.Results Compared with the blank group,the model group rats were mentally lethargic,clustered and curled up,with reduced activity,rough and dull hair,loose and unformed feces,reduced body mass and daily food intake(P<0.05),and gastric emptying rate and small intestine propulsion rate decreased(P<0.01),ICC mitochondria swelled and dissolved,with varying degrees of vacuolar formation,rough endoplasmic reticulum dilation and destruction,and a large number of autophagosomes,the expressions of Beclin1 and LC3 Ⅱ/Ⅰ protein and mRNA in gastric antrum tissue increased(P<0.01),the expressions of p62,c-kit protein and mRNA decreased(P<0.01),while Caspase-3 protein expression increased(P<0.01),and the apoptosis rate of gastric antral tissue cells increased(P<0.01).Compared with the model group,the condition of rats in electroacupuncture group and the Western medicine group were improved,with increased responsiveness,increased mobility,neat hair,formed feces,increased body mass and daily food intake(P<0.01),and gastric emptying rate and small intestine propulsion rate increase(P<0.01),a normal ICC structure,and a small amount of autophagosomes were still visible,the expressions of Beclin1,LC3Ⅱ/Ⅰ protein and mRNA in gastric antrum tissue decreased(P<0.01),the expressions of p62,c-kit protein and mRNA increased(P<0.01),while Caspase-3 protein expression decreased(P<0.01),and the apoptosis rate of gastric antral tissue cells decreased(P<0.01).There was no statistically significant difference in various indicators between electroacupuncture group and Western medicine group(P>0.05).Conclusion Electroacupuncture at"Neiguan"and"Gongsun"can restore the number and structure of ICC and improve gastrointestinal motility,and its mechanism may be related to the inhibition of autophagy and apoptosis levels.

Objective:To investigate the clinical subtypes of acute aortic dissection (AAD) through latent class analysis.Methods:This study was a multicenter retrospective cohort study. Patients with AAD admitted to five hospitals, including Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Henan Provincial People′s Hospital, Central China Fuwai Hospital of Zhengzhou University (Fuwai Central China Cardiovascular Hospital), the Third Affiliated Hospital of Xinxiang Medical University and the Second Affiliated Hospital of Chongqing Medical University, between August 2010 and December 2021 were enrolled. Based on clinical and biological characteristics, latent class analysis (models with 2 to 5 latent classes) was conducted to classify the enrolled patients. The optimal classification scheme was determined using model fitting evaluations, including log-likelihood (LL), entropy, Lo-Mendell-Rubin adjusted likelihood ratio test and so on. Clinical data of different subtypes were compared, and in-hospital mortality was analyzed across the entire population and among subgroups receiving different treatments.Results:A total of 2 689 AAD patients, aged 54 (46, 63) years were included, with 1 305 (48.5%) having DeBakey type Ⅰ, 156 (5.8%) type Ⅱ, and 1 228 (45. 7%) type Ⅲ dissections. The cohort comprised 2 134 (79.4%) males. The overall in-hospital mortality rate was 22.8% (613/2 689). Latent class analysis indicated that a two-class model was optimal (LL=147 413.242, entropy=0.812, and PLMRT<0.001). Patients were classified into two subtypes, named clinical subtype 1 and clinical subtype 2. Compared to clinical subtype 1, clinical subtype 2 had a higher proportion of females, was older, had more dissections involving the ascending aorta, and exhibited higher rates of organ dysfunction (elevated alanine aminotransferase and creatinine levels) and inflammatory response (neutrophilia) (all P<0.05). Clinical subtype 2 also showed higher in-hospital mortality compared to subtype 1 (26.3% (238/905) vs. 21.0% (375/1 784), P=0.002). Among patients undergoing surgical treatment, clinical subtype 2 had higher mortality than subtype 1 (40.1% (67/167) vs. 30.0% (101/337), P=0.027). However, no significant differences in mortality were observed between the two subtypes among patients receiving medical therapy or endovascular and hybrid procedures (all P>0.05). Conclusions:Comprehensive latent class analysis identifies two subtypes of AAD with distinct clinical characteristics and treatment responses. These findings provide new insights into individualized clinical decision-making and prognostic evaluation for AAD patients.

Objective:To explore the potential role of lipoprotein-associated phospholipase A2 (Lp-PLA2) and components of metabolic syndrome (MS) in the early progression of carotid arteriosclerosis.Methods:The study was a cross-sectional study. Urban participants undergoing routine health check-ups were enrolled from all 11 prefecture-level cities in Zhejiang Province between January and December 2022. General clinical information was obtained through interviews, and data on MS was collected from the clinical health examinations. Serum Lp-PLA? levels were measured in all participants. All participants were divided into 3 groups according to the results of the carotid ultrasound: the normal group, the intima thickening group with carotid intima thickening change and the plaque group. Multivariable logistic regression models were used to evaluate the associations of Lp-PLA2, MS, and the components of MS with early carotid atherosclerosis. Receiver operating characteristic (ROC) curve analyses were performed to assess the diagnostic performance of combining Lp-PLA2 with MS and the cumulative number of MS components for early carotid atherosclerosis.Results:A total of 4 009 urban adults undergoing routine health check-ups were enrolled (mean age (48.9±8.46) years, 2 665(66.5 %)male). Of these, 1 398 were in the normal group, 1 650 in the intima thickening group, and 961 in the plaque group. Multivariable logistic regression demonstrated that Lp-PLA2 was independently associated with early carotid atherosclerosis ( OR=1.34, 95% CI: 1.11-1.63, P=0.003). Lp-PLA2 also showed independent positive associations with both carotid intima thickening and carotid plaque formation, with the latter being more pronounced (both P<0.05). MS was independently and positively associated with early carotid atherosclerosis ( OR=1.48, 95 % CI: 1.20-1.84, P<0.001), as well as with intima thickening and carotid plaque formation, with the association being stronger for the latter (both P<0.05). Furthermore, the strength of the association increased progressively with the number of MS components ( P<0.001), especially for carotid plaques formation (both P<0.001). Multivariable logistic regression revealed that, compared with individuals without MS and low Lp-PLA2 levels, the risk of early carotid atherosclerosis was increased in those with high Lp-PLA2 alone, MS alone, or both conditions concurrently, with the highest risk observed when both were present (all P<0.05). ROC analyses demonstrated that the combination of elevated Lp-PLA2 with 3, 4, or 5 MS components yielded good diagnostic performance for early carotid atherosclerosis ( AUC=0.869, 0.888, and 0.889, respectively), intima thickening ( AUC=0.844, 0.860, and 0.845, respectively), and carotid plaque formation ( AUC=0.899, 0.924, and 0.968, respectively) in urban health-screening participants. Conclusions:Lp-PLA2, MS, and the number of MS components were independently and positively associated with early carotid atherosclerosis in urban health chek-up populations. The combination of MS components and Lp-PLA2 provided favorable diagnostic performance for the detection of early carotid atherosclerosis.

Objective To observe the effects of electroacupuncture at"Neiguan"and"Gongsun"on autophagy and apoptosis related indexes of interstitial cells of Cajal(ICC)in rats with functional dyspepsia(FD);To explore its possible mechanism on improving gastrointestinal motility of FD.Methods Totally 32 SPF grade SD rats were randomly divided into blank group,model group,electroacupuncture group and Western medicine group,with 8 rats in each group.An FD model was constructed using a composite etiology modeling method.The electroacupuncture group received electroacupuncture at"Neiguan"and"Gongsun",while the Western medicine group received oral administration of mosapride once a day for 7 consecutive days.The general condition,body mass and average daily intake of rats were observed every week,and gastric emptying rate and small intestine propulsion rate were detected,transmission electron microscopy was used to observe the structure of gastric antrum ICC,Western blot was used to observe the expressions of c-kit,Beclin1,LC3Ⅱ/Ⅰ,p62,Caspase-3 protein in gastric antrum tissue,qPCR was used to observe the mRNA expressions of Beclin1,LC3Ⅱ/Ⅰ,p62 and c-kit in gastric antrum tissue,TUNEL staining was used to detect the apoptosis rate of cells in gastric antrum tissue.Results Compared with the blank group,the model group rats were mentally lethargic,clustered and curled up,with reduced activity,rough and dull hair,loose and unformed feces,reduced body mass and daily food intake(P<0.05),and gastric emptying rate and small intestine propulsion rate decreased(P<0.01),ICC mitochondria swelled and dissolved,with varying degrees of vacuolar formation,rough endoplasmic reticulum dilation and destruction,and a large number of autophagosomes,the expressions of Beclin1 and LC3 Ⅱ/Ⅰ protein and mRNA in gastric antrum tissue increased(P<0.01),the expressions of p62,c-kit protein and mRNA decreased(P<0.01),while Caspase-3 protein expression increased(P<0.01),and the apoptosis rate of gastric antral tissue cells increased(P<0.01).Compared with the model group,the condition of rats in electroacupuncture group and the Western medicine group were improved,with increased responsiveness,increased mobility,neat hair,formed feces,increased body mass and daily food intake(P<0.01),and gastric emptying rate and small intestine propulsion rate increase(P<0.01),a normal ICC structure,and a small amount of autophagosomes were still visible,the expressions of Beclin1,LC3Ⅱ/Ⅰ protein and mRNA in gastric antrum tissue decreased(P<0.01),the expressions of p62,c-kit protein and mRNA increased(P<0.01),while Caspase-3 protein expression decreased(P<0.01),and the apoptosis rate of gastric antral tissue cells decreased(P<0.01).There was no statistically significant difference in various indicators between electroacupuncture group and Western medicine group(P>0.05).Conclusion Electroacupuncture at"Neiguan"and"Gongsun"can restore the number and structure of ICC and improve gastrointestinal motility,and its mechanism may be related to the inhibition of autophagy and apoptosis levels.

The International Association of Pancreatology (IAP) has collaborated with the American Pancreatology Association (APA), the European Pancreatic Club, the Indian Pancreatic Club, and the Japanese Pancreatic Society to revise the 2013 version of "Evidence-Based Guidelines for the Diagnosis and Treatment of Acute Pancreatitis," which was published in July 2025 in the IAP official journal "Pancreatology." The updated guidelines were based on the latest evidence-based research and provide recommendations or best practice statements for 96 clinical questions across 19 domains, covering nearly all aspects of the diagnosis and treatment of acute pancreatitis. Key areas included fluid resuscitation, pain management, nutritional support, conservative and interventional treatment for infectious pancreatic necrosis, management of complications, discharge criteria, follow-up guidelines, and strategies for preventing recurrence. Additionally, the new version introduced the management of special types of acute pancreatitis (such as pancreatitis associated with pregnancy, trauma, and metabolic factors) and innovatively incorporated "best practice statements" to provide guidance for clinical issues with insufficient evidence. This article interpretes the main content of the 2025 International Acute Pancreatitis Guidelines via integrating previous domestic and international guidelines and clinical practices, with the aim of providing reference for domestic clinicians in the diagnosis and treatment of acute pancreatitis.

Objective To verify the applicability of a pig STR multiplex amplification system for detecting processed foods containing pork and their digestive samples,and to evaluate its potential in food safety and forensic biological evidence analysis.Methods DNA profiles were obtained using the pig STR amplification system from food samples with different levels of processing(raw pork,boiled pork,fried pork,and sausage)and from digestive samples(rat gastric contents).The influence of processing methods on DNA integrity was assessed.The uniformity of large-scale processed ham products,the consistency of DNA profiles from different parts of the same sample,and the DNA degradation patterns after rat digestion were examined.Results STR profiling of pig DNA was successful in all tested samples.Short fragments showed high amplification stability,while long fragment signals weakened with increasing processing complexity.In processed ham products,DNA profiles were consistent across all sampled parts,with fragment drift within±0.5 bp.Analysis of rat gastric contents showed slight DNA degradation within 2 hours;after 3 hours,long fragment signals weakened,and after 4 hours,some loci signals were lost.Conclusion The pig STR multiplex amplification system exhibits excellent performance in detecting processed pork products and their digestive samples.It can meet the requirements of food traceability and forensic biological evidence analysis for processed pork,providing new insights for the advancement of forensic testing techniques in this field.

BACKGROUND:The highest incidence of spinal fracture is in the thoracolumbar segment,and its symptoms are back pain,posterior convexity deformity,activity limitation,or with spinal cord nerve injury causing lower limb pain,numbness,and even paraplegia and other complications.The finite element method is a digital computer modeling technique,which can simulate the physical model and carry out force analysis realistically.OBJECTIVE:To review the application of finite element method in thoracolumbar spine fractures.METHODS:We searched the Chinese and English literature databases PubMed,Web of Science,and CNKI for relevant literature on the application of the finite element analysis method in spinal thoracolumbar fracture published before March 2024.The search terms in Chinese and English were:finite element analysis methods,biomechanical phenomena,stress analysis,thoracolumbar fractures,spinal fractures.Finally,55 papers were included.RESULTS AND CONCLUSION:(1)The exploration of thoracolumbar fractures caused by different etiologies(osteoporotic,traumatic,and pathological)through the finite element method is conducive to a deeper understanding of the biomechanics of various types of thoracolumbar fractures,and to improve the individualized and fine-tuned treatment of thoracolumbar fractures.(2)The finite element analysis of a single sample or a small number of samples has the chance,and a larger number of samples are required for the future finite element analysis to reduce the chance caused by the sample.(3)The rigid structure of bones alone cannot meet the biomechanical working conditions of the integrity of the physical object,and future finite element models need to incorporate all the structures of the physical object(e.g.,soft tissues,such as muscles and ligaments)as far as possible.(4)The finite element method has been used in more studies on osteoporotic and traumatic thoracolumbar spine fractures,which will need to be more in-depth in the future,and less in the field of pathologic thoracolumbar fractures,which has a wider scope for future research.

Objective:To explore the potential role of lipoprotein-associated phospholipase A2 (Lp-PLA2) and components of metabolic syndrome (MS) in the early progression of carotid arteriosclerosis.Methods:The study was a cross-sectional study. Urban participants undergoing routine health check-ups were enrolled from all 11 prefecture-level cities in Zhejiang Province between January and December 2022. General clinical information was obtained through interviews, and data on MS was collected from the clinical health examinations. Serum Lp-PLA? levels were measured in all participants. All participants were divided into 3 groups according to the results of the carotid ultrasound: the normal group, the intima thickening group with carotid intima thickening change and the plaque group. Multivariable logistic regression models were used to evaluate the associations of Lp-PLA2, MS, and the components of MS with early carotid atherosclerosis. Receiver operating characteristic (ROC) curve analyses were performed to assess the diagnostic performance of combining Lp-PLA2 with MS and the cumulative number of MS components for early carotid atherosclerosis.Results:A total of 4 009 urban adults undergoing routine health check-ups were enrolled (mean age (48.9±8.46) years, 2 665(66.5 %)male). Of these, 1 398 were in the normal group, 1 650 in the intima thickening group, and 961 in the plaque group. Multivariable logistic regression demonstrated that Lp-PLA2 was independently associated with early carotid atherosclerosis ( OR=1.34, 95% CI: 1.11-1.63, P=0.003). Lp-PLA2 also showed independent positive associations with both carotid intima thickening and carotid plaque formation, with the latter being more pronounced (both P<0.05). MS was independently and positively associated with early carotid atherosclerosis ( OR=1.48, 95 % CI: 1.20-1.84, P<0.001), as well as with intima thickening and carotid plaque formation, with the association being stronger for the latter (both P<0.05). Furthermore, the strength of the association increased progressively with the number of MS components ( P<0.001), especially for carotid plaques formation (both P<0.001). Multivariable logistic regression revealed that, compared with individuals without MS and low Lp-PLA2 levels, the risk of early carotid atherosclerosis was increased in those with high Lp-PLA2 alone, MS alone, or both conditions concurrently, with the highest risk observed when both were present (all P<0.05). ROC analyses demonstrated that the combination of elevated Lp-PLA2 with 3, 4, or 5 MS components yielded good diagnostic performance for early carotid atherosclerosis ( AUC=0.869, 0.888, and 0.889, respectively), intima thickening ( AUC=0.844, 0.860, and 0.845, respectively), and carotid plaque formation ( AUC=0.899, 0.924, and 0.968, respectively) in urban health-screening participants. Conclusions:Lp-PLA2, MS, and the number of MS components were independently and positively associated with early carotid atherosclerosis in urban health chek-up populations. The combination of MS components and Lp-PLA2 provided favorable diagnostic performance for the detection of early carotid atherosclerosis.

Objective To target at the NKG2A-HLA-E inhibitory axis,a pluripotent stem cell(iPSC)-derived geneti-cally engineered natural killer cells(NK cells)with NKG2A knockout(NKG2A KO-iNK)were prepared and then their tumor-killing efficacy was evaluated in vitro.Methods NKG2A was knocked out in iPSCs using gene-editing technology.These cells were then differentiated into NKG2A KO-iNK cells.Surface markers at each differentiation stage were analyzed by flow cytometry.Western blot confirmed NKG2A knockout,and flow cytometry assessed expres-sion of activating receptors(NKG2D)and natural cytotoxicity receptors(NKp30,NKp44,NKp46)in NKG2A KO-iNK cells.Cytotoxic activity against tumor cell lines with varying human leukocyte antigen E(HLA-E)expression level was evaluated via lactate dehydrogenase(LDH)release assay.Results Co-transfection of iPSCs with Cas9 pro-tein and three small-guide RNAs(sgRNAs)targeting at exons 1 and 2 of the KLRC1 gene(encoding NKG2A)suc-cessfully generated monoclonal NKG2A-knockout iPSCs(NKG2A KO-iPSCs)with a single T-base insertion in exon 1.During iPSC differentiation into NK cells,CD34 expression reached 30％-50％at the embryoid body(EB)stage(day 8),while CD56 and CD 16 expression exceeded 80％by day 28.Western blot confirmed complete NKG2A knockout in NKG2A KO-iNK cells.Flow cytometry revealed comparable expression level of activating receptor NKG2D and cytotox-icity receptors(NKp30,NKp44,NKp46)between NKG2A KO-iNK and wild-type iNK(WT-iNK)cells.The LDH assay results indicated that the cytotoxic activity of NKG2A KO-iNK cells against the HLA-E highly-expressed B-cell precursor leukemia cell line Nalm6 cells was significantly higher than that of WT-iNK cells,while there was no signif-icant difference between them and human myeloma cell line H929 cells with low HLA-E expression and human hepa-tocellular carcinoma cell line HepG2 cells with almost no HLA-E expression.Interferon-γ(IFN-γ)pretreatment up regulated HLA-E expression in Nalm6 cells,further amplifying NKG2A KO-iNK-mediated cytotoxicity.Conclusions By disrupting the NKG2A-HLA-E inhibitory axis,NKG2A KO-iNK cells exhibit markedly enhanced in vitro cytotoxic-ity against HLA-E-high tumor cells.This result highlights their potential function as a novel adoptive cell therapy strategy for cancers reliant on HLA-E-mediated immune evasion.

Objective To investigate the application effect of postural gravity traction combined with floss and titanium clip pulley external traction in endoscopic submucosal dissection(ESD)for early intestinal lesions.Methods A total of 100 patients with early colorectal lesions admitted to the Affiliated Hospital of Jiangsu University from January 2022 to September 2024 were selected as the research subjects and divided in-to the observation group and the control group,with 50 cases in each group.The control group underwent con-ventional intestinal ESD treatment,while the observation group used positional gravity traction combined with dental floss and titanium clips to form pulley external traction in ESD treatment.Clinical data including opera-tion time,number of submucosal injections,intraoperative blood loss,lesion resection effect,complication inci-dence,and hospital stay were compared between the two groups.Results The total operation time in the ob-servation group was shorter than that in the control group,and the total number of submucosal injections was less than that in the control group,with statistically significant differences(P<0.05).There were no signifi-cant differences in intraoperative blood loss,complete resection rate,complication incidence,en bloc resection rate,and hospital stay between the two groups(P>0.05).For lesions≤1 cm or>5 cm in size,there were no significant differences in operation time,complete resection rate and en bloc resection rate between the two groups(P>0.05).For lesions>1-3 cm or>3-5 cm in size and laterally spreading lesions,significant differences were observed in operation time,number of submucosal injections,complete resection rate,and en bloc resection rate between the two groups(P<0.05).For pedunculated polyps,there were no significant differences in the number of submucosal injections,complete resection rate and en bloc resection rate between the two groups(P>0.05),but the operation time differed significantly(P<0.05).Conclusion Postural gravity traction combined with dental floss and titanium clip to form pulley external traction is simple to oper-ate in ESD for early intestinal lesions.It can maintain a clear field of view,shorten operation time,reduce the incidence of complications,and is safe and effective.