ObjectiveTo investigate the safety and efficacy of transparent cap-assisted peroral cholangiopancreatoscopy-guided electrohydraulic lithotripsy （EHL）. MethodsA retrospective analysis was performed for the clinical data of 60 patients with large common bile duct stones who were admitted to Department of Gastroenterology， Jilin People’s Hospital， from May 1， 2023 to January 31， 2026， and according to the treatment method， the patients were divided into transparent cap-assisted peroral cholangiopancreatoscopy-guided electrohydraulic lithotripsy group and peroral cholangiopancreatoscopy-guided electrohydraulic lithotripsy group， with 30 patients in each group. The two groups were compared in terms of the rate of successful single-session stone fragmentation and removal， procedural time， duration of electrohydraulic lithotripsy， clinical success rate， and complications. The independent-samples t test or the Mann-Whitney U test was used for comparison of continuous data between two groups， and the chi-square test or the Fisher’s exact test was used for comparison of categorical data between two groups. ResultsCompared with the peroral cholangiopancreatoscopy-guided electrohydraulic lithotripsy group， the transparent cap-assisted peroral cholangiopancreatoscopy-guided electrohydraulic lithotripsy group had a significantly higher technical success rate （83.33% vs 60.00%， χ²=4.022， P=0.045） and significantly shorter procedural time ［46.00 （42.25 — 49.00） min vs 54.50 （42.00 — 65.00） min， Z=2.012， P=0.044］ and duration of electrohydraulic lithotripsy ［8.00 （6.25 — 11.75） min vs 13.50 （9.25 — 17.75） min， Z=2.749， P=0.006］. Both groups achieved a clinical success rate of 100%， with no significant difference in the incidence rate of complications （P>0.05）. ConclusionTransparent cap-assisted peroral cholangiopancreatoscopy-guided electrohydraulic lithotripsy has a high rate of successful single-session stone fragmentation and removal and a short procedural time， with good safety and efficacy， and therefore， it holds promise for clinical application.

Adenomyosis(AM)is a common gynecologic disease,which could be more accurately diagnosed based on morphological uterus sonographic assessment(MUSA)criteria.MUSA criteria and clinical application for diagnosing AM were reviewed in this article.

Objective:This study aims to investigate the differences between two groups of patients treated with nucleos（t）ide analogues（NAs）：those with undetectable HBV DNA by ultrasensitive testing and those with HBV DNA below the quantification limit. The findings will provide a basis for the clinical interpretation and rational use of ultrasensitive HBV DNA results.Methods:This cross-sectional study included patients with chronic HBV infection who were treated with NAs between May 2023 and December 2023 at the outpatient clinic and inpatient department of the Hepatology Department，The Second Hospital of Shandong University. All patients had ultrasensitive HBV DNA results that were either undetectable or less than 20 IU/ml. The group with undetectable ultrasensitive HBV DNA was defined as the target not detected（TND）group，while the group with HBV DNA levels below 20 IU/ml was defined as the limit of quantitation（LOQ）group. Data on patients' sex，age，type of NAs used，routine blood tests，liver and kidney function，quantitative hepatitis B serology，ultrasensitive HBV DNA，HBV pregenomic RNA（pgRNA），abdominal ultrasound，CT or MRI imaging were collected. Differences between the two groups in terms of demographic data and HBV markers were analyzed.Results:A total of 827 patients were included in the study，with 536 patients in the TND group and 291 in the LOQ group. Compared with the TND group，the LOQ group had a younger age（ P<0.001），and higher level of ALT，AST，HBeAg positive rate，HBsAg，and HBV pgRNA（all P<0.001）. Subgroup analyses stratified by HBeAg status，cirrhosis status，and sex showed that the LOQ group had significantly higher levels of HBsAg and HBV pgRNA compared to the TND group in all subgroups（all P<0.05）. Conclusion:The LOQ group had significantly higher levels of HBsAg and HBV pgRNA compared to the TND group.

AIM:To investigate the preventive and therapeutic effects of sesamin(SES)on fatty liver disease in rats with hypertension combined with dyslipidemia,and to explore the potential mecha-nisms based on mRNA-seq.METHODS:Spontane-ously hypertensive rats(SHRs)were fed a high-fat,high-cholesterol diet to establish a rat model of hy-pertension combined with dyslipidemia,and then treated with SES for 16 weeks continuously.The ex-periment was divided into four groups:WKY,SHR,Model,and Model+SES(160 mg·kg-1·d-1).Blood pressure was measured using the tail-cuff method.Body weight was monitored,and body mass index was calculated.Liver morphology was detected by ultrasound,and liver thickness was measured.Liver wet weight was weighed,and liver index was calcu-lated.Liver volume was detected by the water dis-placement method.Serum triglycerides(TG),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),alanine aminotransferase(ALT),aspartate amino-transferase(AST),and total bile acids(TBA)were de-tected by ELISA.Liver sequencing analysis was per-formed using mRNA-seq.Liver histomorphological changes were observed by HE staining.The degree of hepatic steatosis was observed by Oil Red O stain-ing,and the degree of hepatic fibrosis was observed by MASSON staining.The mRNA expression of Al-dh1a7,Nnmt,Irs2,Pltp,and Scd was detected by q-PCR.The protein expression of Scd,Nnmt,AMPK,p-AMPK,PPARα,and PPARγ was detected by Western blotting.RESULTS:After 16 weeks of continuous SES administration to rats with hypertension combined with dyslipidemia,blood pressure was significantly reduced(P＜0.01),and body weight was decreased.Serum TG,TC,and LDL-C levels were decreased,while HDL-C levels were increased.Serum ALT and AST levels were decreased.Liver weight,organ in-dex,liver thickness,and liver volume were de-creased.The degree of hepatic steatosis and hepat-ic fibrosis was improved.A total of 545 differentially expressed mRNAs were identified in the livers of rats in each group,of which 278 were upregulated and 267 were downregulated.Among the 27 com-monly differentially expressed mRNAs,five mRNAs related to lipid metabolism were screened,namely Aldh1a7,Nnmt,Irs2,Pltp,and Scd.KEGG enrich-ment analysis showed that the enriched pathways were AMPK and PPAR.Further validation revealed that in the SES-treated group,the mRNA expression of Scd in the liver was decreased,while the mRNA expression of Nnmt was increased.The protein ex-pression of Scd was decreased,while the protein ex-pression of Nnmt,AMPK,p-AMPK,PPARα,and PPARγ was increased.CONCLUSION:SES has preven-tive and therapeutic effects on fatty liver disease in rats with hypertension combined with dyslipidemia,and its mechanism of action may be related to the reduction of Scd expression levels in the liver and the increase in the expression of Nnmt,AMPK,p-AMPK,PPARα,and PPARγ.

Objective:To investigate the difference in intracranial infection rate between long-tunneled external ventricular drainage(LTEVD)and conventional external ventricular drainage(EVD),as well as the risk factors for intracranial infection.Methods:A retro-spective analysis was performed for the clinical data of 45 patients who were admitted to Department of Neurology Center,The Third Affiliated Hospital of Chongqing Medical University,from January 2020 to December 2022 and underwent EVD,among whom 13 patients underwent LTEVD(LTEVD group)and 32 patients underwent conventional EVD(EVD group).Related data were recorded for both groups,including general information,postoperative catheter-related complications,and postoperative management,to investi-gate the effect on reducing the rate of intracranial infection.According to the presence or absence of intracranial infection after surgery,the patients were divided into the infection group with 10 patients and non-infection group with 35 patients,and related clini-cal data were analyzed to investigate the risk factors for intracranial infection.Results:The LTEVD group had a significantly lower secondary infection rate of catheterization days than the EVD group[2.40‰(1/417)vs.27.19‰(9/331),P=0.009].The duration of catheterization was 14-85 days[27.00(22.50,36.50)days]in the LTEVD group and 8-22 days[9.00(8.00,11.50)days]in the EVD group,suggesting that the LTEVD group had a significantly longer duration of catheterization than the EVD group(P=0.000).The multivariate logistic regression analysis showed that the times of cerebrospinal fluid sampling was an independent risk factor for post-operative intracranial infection in patients undergoing EVD,and the use of LTEVD was a protective factor against intracranial infection after EVD.Conclusion:Compared with conventional EVD,LTEVD can safely prolong the duration of catheterization and reduce the rate of postoperative intracranial infection in patients undergoing EVD.The use of LTEVD procedure and the reduction in the times of cerebrospinal fluid sampling can reduce the risk of postoperative in-tracranial infection.

Type 2 inflammation（T2 inflammation）is an immune response mediated by Th2 cells，eosinophils，type 2 innate lymphocytes，and other cells. Its pathological characteristics are manifested by the abnormally high expression of type 2 cytokines such as IL-4，IL-5，and IL-13，and it widely involves allergic diseases including asthma，allergic rhinitis，and atopic dermatitis. Ginsenosides are the core active ingredients of ginseng and the key substances for ginseng to exert its pharmacological effects. It has anti-inflammatory and immunomodulatory effects. This article reviews the mechanism of action，experimental research progress，and clinical application prospects of ginsenosides in T2 inflammation，explores the therapeutic potential and clinical challenges of ginsenosides，and proposes future research directions.

Adenomyosis(AM)is a common gynecologic disease,which could be more accurately diagnosed based on morphological uterus sonographic assessment(MUSA)criteria.MUSA criteria and clinical application for diagnosing AM were reviewed in this article.

AIM:To investigate the preventive and therapeutic effects of sesamin(SES)on fatty liver disease in rats with hypertension combined with dyslipidemia,and to explore the potential mecha-nisms based on mRNA-seq.METHODS:Spontane-ously hypertensive rats(SHRs)were fed a high-fat,high-cholesterol diet to establish a rat model of hy-pertension combined with dyslipidemia,and then treated with SES for 16 weeks continuously.The ex-periment was divided into four groups:WKY,SHR,Model,and Model+SES(160 mg·kg-1·d-1).Blood pressure was measured using the tail-cuff method.Body weight was monitored,and body mass index was calculated.Liver morphology was detected by ultrasound,and liver thickness was measured.Liver wet weight was weighed,and liver index was calcu-lated.Liver volume was detected by the water dis-placement method.Serum triglycerides(TG),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),alanine aminotransferase(ALT),aspartate amino-transferase(AST),and total bile acids(TBA)were de-tected by ELISA.Liver sequencing analysis was per-formed using mRNA-seq.Liver histomorphological changes were observed by HE staining.The degree of hepatic steatosis was observed by Oil Red O stain-ing,and the degree of hepatic fibrosis was observed by MASSON staining.The mRNA expression of Al-dh1a7,Nnmt,Irs2,Pltp,and Scd was detected by q-PCR.The protein expression of Scd,Nnmt,AMPK,p-AMPK,PPARα,and PPARγ was detected by Western blotting.RESULTS:After 16 weeks of continuous SES administration to rats with hypertension combined with dyslipidemia,blood pressure was significantly reduced(P＜0.01),and body weight was decreased.Serum TG,TC,and LDL-C levels were decreased,while HDL-C levels were increased.Serum ALT and AST levels were decreased.Liver weight,organ in-dex,liver thickness,and liver volume were de-creased.The degree of hepatic steatosis and hepat-ic fibrosis was improved.A total of 545 differentially expressed mRNAs were identified in the livers of rats in each group,of which 278 were upregulated and 267 were downregulated.Among the 27 com-monly differentially expressed mRNAs,five mRNAs related to lipid metabolism were screened,namely Aldh1a7,Nnmt,Irs2,Pltp,and Scd.KEGG enrich-ment analysis showed that the enriched pathways were AMPK and PPAR.Further validation revealed that in the SES-treated group,the mRNA expression of Scd in the liver was decreased,while the mRNA expression of Nnmt was increased.The protein ex-pression of Scd was decreased,while the protein ex-pression of Nnmt,AMPK,p-AMPK,PPARα,and PPARγ was increased.CONCLUSION:SES has preven-tive and therapeutic effects on fatty liver disease in rats with hypertension combined with dyslipidemia,and its mechanism of action may be related to the reduction of Scd expression levels in the liver and the increase in the expression of Nnmt,AMPK,p-AMPK,PPARα,and PPARγ.

Objective:This study aims to investigate the differences between two groups of patients treated with nucleos（t）ide analogues（NAs）：those with undetectable HBV DNA by ultrasensitive testing and those with HBV DNA below the quantification limit. The findings will provide a basis for the clinical interpretation and rational use of ultrasensitive HBV DNA results.Methods:This cross-sectional study included patients with chronic HBV infection who were treated with NAs between May 2023 and December 2023 at the outpatient clinic and inpatient department of the Hepatology Department，The Second Hospital of Shandong University. All patients had ultrasensitive HBV DNA results that were either undetectable or less than 20 IU/ml. The group with undetectable ultrasensitive HBV DNA was defined as the target not detected（TND）group，while the group with HBV DNA levels below 20 IU/ml was defined as the limit of quantitation（LOQ）group. Data on patients' sex，age，type of NAs used，routine blood tests，liver and kidney function，quantitative hepatitis B serology，ultrasensitive HBV DNA，HBV pregenomic RNA（pgRNA），abdominal ultrasound，CT or MRI imaging were collected. Differences between the two groups in terms of demographic data and HBV markers were analyzed.Results:A total of 827 patients were included in the study，with 536 patients in the TND group and 291 in the LOQ group. Compared with the TND group，the LOQ group had a younger age（ P<0.001），and higher level of ALT，AST，HBeAg positive rate，HBsAg，and HBV pgRNA（all P<0.001）. Subgroup analyses stratified by HBeAg status，cirrhosis status，and sex showed that the LOQ group had significantly higher levels of HBsAg and HBV pgRNA compared to the TND group in all subgroups（all P<0.05）. Conclusion:The LOQ group had significantly higher levels of HBsAg and HBV pgRNA compared to the TND group.

Medical microbiology experiment is faced with many problems in online teaching. This study adopts the teaching mode of online live broadcast + operation video + virtual experiment, and make up the operation gap to some extent through operation video and virtual experiment. The mode of assessment is subjective thinking question (closely following the operation process) + experiment design + literature review (focusing on the key technology or new technology of clinical assessment that cannot be carried out due to the limitation of conditions in traditional experiments, such as mass spectrometry, fluorescence quantitative PCR, and G-test), and it is helpful to understand students' mastery of teaching objectives, and the ability of comprehensive application and innovative thinking. The student questionnaire shows that most students hold a positive attitude towards the online experimental teaching mode, and the quality of students' homework shows that most students have a good learning effect.