Objective:To investigate the pathological characteristics of post-cholecystectomy specimens from patients with benign gallbladder diseases.Methods:This retrospective case series study analyzed clinical and pathological data from 1 712 patients who underwent cholecystectomy for benign gallbladder diseases at the Sixth People′s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine between September 2022 and August 2024. The cohort included 757 males and 955 females, with an age ( M(IQR)) of 57(23) years (range: 14 to 91 years). Clinical and pathological features were analyzed. The χ2 test was used to compare clinical characteristics between patients with neoplastic and non-neoplastic polyps. Factors statistically significant in the χ2 test were subsequently included in a binary logistic regression analysis. Results:Postoperative pathological examination revealed gallbladder cancer in 7 patients (0.41%). These 7 cases, including 2 with pT3 stage cancer, were not detected preoperatively by various imaging examinations (ultrasound+magnetic resonance cholangiopancreatography/MRI plain scan in 3 cases, ultrasound+enhanced MRI in 1 case, ultrasound+enhanced CT in 2 cases, enhanced CT+enhanced MRI in 1 case). Gallbladder adenoma was found in 23 cases (1.34%), neoplastic polyps (including cholesterol polyps with dysplasia) in 29 cases (1.69%), and non-neoplastic polyps in 154 cases (9.00%). Statistically significant differences were observed in age and polyp number between patients with neoplastic and non-neoplastic polyps ( χ2=10.436 and 8.030; both P<0.05). Binary logistic regression analysis identified age ≥60 years ( P=0.003) and solitary polyps ( P=0.009) as risk factors for neoplastic polyps. Mucosal dysplasia was present in 164 cases (9.58%), including 9 cases of severe dysplasia, 4 of which exhibited focal carcinomatous transformation. Gallbladder polyps combined with stones were found in 90 cases (5.26%), among which 10 were associated with adenoma and mucosal dysplasia, and 2 showed focal carcinomatous transformation. Conclusions:The incidence of incidental gallbladder carcinoma was 0.41%. Intraoperative bile spillage can severely compromise prognosis. Preoperative imaging demonstrates a low detection rate for neoplastic polyps. Particular vigilance for neoplastic polyps is warranted in patients aged ≥60 years or with solitary polyps. Cholecystectomy should be performed promptly for benign gallbladder diseases meeting surgical indications.

Objective:To investigate the pathological characteristics of post-cholecystectomy specimens from patients with benign gallbladder diseases.Methods:This retrospective case series study analyzed clinical and pathological data from 1 712 patients who underwent cholecystectomy for benign gallbladder diseases at the Sixth People′s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine between September 2022 and August 2024. The cohort included 757 males and 955 females, with an age ( M(IQR)) of 57(23) years (range: 14 to 91 years). Clinical and pathological features were analyzed. The χ2 test was used to compare clinical characteristics between patients with neoplastic and non-neoplastic polyps. Factors statistically significant in the χ2 test were subsequently included in a binary logistic regression analysis. Results:Postoperative pathological examination revealed gallbladder cancer in 7 patients (0.41%). These 7 cases, including 2 with pT3 stage cancer, were not detected preoperatively by various imaging examinations (ultrasound+magnetic resonance cholangiopancreatography/MRI plain scan in 3 cases, ultrasound+enhanced MRI in 1 case, ultrasound+enhanced CT in 2 cases, enhanced CT+enhanced MRI in 1 case). Gallbladder adenoma was found in 23 cases (1.34%), neoplastic polyps (including cholesterol polyps with dysplasia) in 29 cases (1.69%), and non-neoplastic polyps in 154 cases (9.00%). Statistically significant differences were observed in age and polyp number between patients with neoplastic and non-neoplastic polyps ( χ2=10.436 and 8.030; both P<0.05). Binary logistic regression analysis identified age ≥60 years ( P=0.003) and solitary polyps ( P=0.009) as risk factors for neoplastic polyps. Mucosal dysplasia was present in 164 cases (9.58%), including 9 cases of severe dysplasia, 4 of which exhibited focal carcinomatous transformation. Gallbladder polyps combined with stones were found in 90 cases (5.26%), among which 10 were associated with adenoma and mucosal dysplasia, and 2 showed focal carcinomatous transformation. Conclusions:The incidence of incidental gallbladder carcinoma was 0.41%. Intraoperative bile spillage can severely compromise prognosis. Preoperative imaging demonstrates a low detection rate for neoplastic polyps. Particular vigilance for neoplastic polyps is warranted in patients aged ≥60 years or with solitary polyps. Cholecystectomy should be performed promptly for benign gallbladder diseases meeting surgical indications.

Sinopodophyllum hexandruma is a traditional Chinese medicine in China,which is mostly distributed in Gansu,Shaanxi,Sichuan,Qinghai,Yunnan and Xizang,etc.In recent years,with the gradual deepening of the research on the chemical composition and pharmacology-toxicology of Sinopodophyllum hexandruma,its antitumour and antiviral pharmacodynamic evaluation has increasingly become a research hotspot in the industry.Based on the chemical structure,pharmacological properties and the theoretical basis of quality markers(Q-markers),this paper presents an in-depth literature review and analysis of the chemical composition,pharmacological activities and Q-markers of Sinopodophyllum hexandruma,and systematically explores and predicts the Q-markers of Sinopodophyllum hexandruma.It is proposed that Podophyllotoxin,picropodophyllotoxin,podophyllotoxinone,quercetin,kaempferol,quercetin-3-O-β-glucoside can be used as the Q-marker of Sinopodophyllum hexandruma.In the later stage,these index components can be selected to control the whole quality of Sinopodophyllum hexandrum,and provide some data support and theoretical reference for the quality evaluation of Sinopodophyllum hexandrum.

Objective:To explore the protective effect of sesquiterpene lactones of Eupatorium lindleyanum DC.(SLEL)on lipopolysac-charide(LPS)-induced acute lung injury(ALI)in rats using metabolomics.Methods:Forty-eight male SD rats were randomly divided into a blank control group(CG),a model control group(MG),low-,medium-,and high-dose SLEL groups(50,100,and 200 mg/kg),and a positive control group(dexamethasone acetate tablets,5 mg/kg).CG and MG groups were given phosphate-buffered saline.All groups received intragastric administration at a dose volume of 10 mL/kg once a day for 7 consecutive days.One hour after the last ad-ministration,LPS(5 mg/kg)was instilled into the trachea of all groups except the CG group to establish the ALI rat model.Twenty-four hours after model establishment,blood was collected from the abdominal aorta and bronchoalveolar lavage fluid(BALF)was col-lected from the left lung.The total number of inflammatory cells,neutrophils,lymphocytes,and eosinophils in BALF was counted by Wright-Giemsa staining.The levels of interleukin-18(IL-18)and interferon-γ(IFN-γ)in serum and BALF were measured by enzyme-linked immunosorbent assay.The pathological changes of lung tissue were observed using hematoxylin-eosin staining.The ex-pression levels of tight junction protein-1(ZO-1)and occludin in lung tissue were determined by Western blot.The mRNA expression levels of IL-18,IFN-γ,ZO-1,and occludin in the lung were measured by real-time fluorescence quantitative PCR.Non-targeted me-tabolomics analysis of serum and lung tissue was performed using ultra-performance liquid chromatography-electrospray ionization-tandem mass spectrometry.Results:Compared with the MG group,all SLEL groups had significantly reduced wet/dry weight ratio of lung tissue,lung coefficient,and total number of inflammatory cells,neutrophils,lymphocytes,and eosinophils in BALF.SLEL signifi-cantly decreased the levels of IL-18 and IFN-γ in serum and BALF and the mRNA expression of IL-18 and IFN-γ in lung tissue,and significantly promoted the protein and mRNA expression of ZO-1 and occludin.Under light microscopy,the degree of lung tissue edema,alveolar hemorrhage,and inflammatory cell infiltration were significantly reduced,indicating a certain protective effect on ALI rats.The results of non-targeted metabolomics studies showed that there were 91 and 33 significantly different metabolites in the serum and lung tissue of rats treated with SLEL,respectively.Among them,the main differential metabolites in the serum were sphingosine,L-lactic acid,nicotinic acid,D-nucleotide,and mevalonate-5P,while the main differential metabolites in the lung tissue were tauro-cholic acid.This suggests that SLEL may mainly affect the metabolic pathways of sphingolipids,pyruvate,nicotinic acid,nicotinamide,and tryptophan in the serum and the metabolic pathways of taurine and hypotaurine in the lung tissue to improve ALI.Conclusion:SLEL has a significant protective effect on rats against LPS-induced ALI,and its mechanism of action may be related to the inhibition of inflammatory factors,improvement of lung barrier function,and regulation of related metabolic pathways.

Objective:To analyze the changes of DNA methylation in peripheral blood mononuclear cells (PBMC) of patients with hepatocellular carcinoma (HCC) and to evaluate the clinical value of a combined model based on FSIP1 gene methylation on the early diagnosis of HCC.Methods:This is a case-control study. From May 2023 to September 2024, 183 HCC patients and 155 healthy controls were collected in Qilu Hospital of Shandong University. The selected study subjects were divided into three cohorts: 14 HCC patients and 39 healthy controls formed the discovery cohort, a screening cohort consisted of 36 HCC patients and 39 healthy controls, 133 HCC patients and 77 healthy controls were included in the model construction cohort. 935k methylation chip analysis was used to identify specific differentially methylated sites in peripheral blood PBMC of the discovery cohort. The absolute value of the average methylation level difference between HCC group and healthy control group (|Δβ|) and P value were calculated. Then targeted bisulfite sequencing was used to verify the differentially methylated sites in the screening cohort. Finally, based on MethylTarget methylation sequencing technology, differential methylation sites were further verified in model construction cohort (divided into training set and validation set, training set consisted of 99 HCC patients and 57 healthy controls; validation set consisted of 34 HCC patients and 20 healthy controls). HCC early diagnosis model was constructed by random forest algorithm combined with clinical parameters and the diagnostic performance of the model was evaluated by receiver operating characteristic (ROC) curve in the validation set. Results:The total of 7 249 differentially methylated sites between HCC patients and healthy controls in discovery cohort were selected under the rule of |Δβ|≥0.06 and P<0.01. Among them, the cg02155073 site located on FSIP1 was hypermethylated in PBMC of HCC patients in the screening cohort and model cohort ( P<0.001). The AUC of HCC early diagnosis model (FmAP) based on FSIPI in the validation set was 0.967 (95% CI 0.924-1.000); sensitivity was 88%, specificity was 95%. The model had good diagnostic efficacy for patients with early HCC, stage Ⅰ-Ⅱ HCC AUC was 0.958 (95% CI 0.898-1.000). The FmAP model also had diagnostic value for tumor size <2 cm HCC and AFP negative HCC, with AUC of 0.955 (95% CI 0.898-1.000) and 0.964 (95% CI 0.934-0.994).The sensitivity were 92% and 93% and specificity both were 84%. Conclusion:The FmAP model based on FSIP1 gene methylation has good clinical value for the early diagnosis of hepatocellular carcinoma.

Objective: To explore the application effect of a guided self help intervention based on dialectical behavior therapy (DBT) to address non suicidal self injury (NSSI) behavior among college students, so as to provide a reference for reducing the occurrence of NSSI behavior in this population. Methods: A total of 106 college students with NSSI admitted to the Department of Child and Adolescent Psychology, the Second Affiliated Hospital of Jining Medical University from January 2021 to January 2023 were selected and divided into an observation group and a control group, with 53 cases in each group, using a random number table method. The control group received routine medication treatment and psychological intervention, while the observation group, on the basis of the interventions provided to the control group, implemented dialectical behavior therapy based guided self help. The approach combines group activities, individual counseling, and selfdirected learning, covering four core modules: mindfulness training, distress tolerance, interpersonal effectiveness, and emotion regulation. Meanwhile, data collection, skill check ins, and personalized recommendation pushes were conducted through a WeChat. Both groups were intervented for 12 weeks. Before the intervention and after the intervention, the Adolescent Non suicidal Self injury Behavior Questionnaire, Ottawa Self injury Inventory (OSI), and Barratt Impulsiveness Scale (BIS) were used to evaluate the patients, and the levels of serum neurotransmitters were detected. The χ 2 test, t test, and Cochran s Q test were used for data comparison and analysis. Results: The incidence rates of NSSI in the observation group after 3, 6, and 12 weeks of intervention were 47.17%, 16.98%, and 5.66%, respectively, all lower than those in the control group (67.92%, 35.85%, 20.75%) ( χ 2=4.67, 4.85, 5.27,all P <0.05). After 12 weeks of intervention, in the NSSI Behavior Questionnaire, the total score of the observation group was (17.94±2.69) points, which was lower than that of the control group (23.04±5.11) points; in the Function Questionnaire, the total score of the observation group was (53.24±8.94) points, which was higher than that of the control group (47.74±8.00) points（both P ＜0.05）. In terms of the OSI, the total score of the observation group was (4.49±0.62) points, lower than that of the control group (6.25±0.81) points;in the BIS, the total score of the observation group was (80.76±7.94) points, lower than that of the control group (87.74±9.34) points，and the differences between groups were statistically significant(both P<0.05). After the intervention, the level of 5-hydroxytryptamine in the observation group was (67.93±5.42) ng/mL, higher than (44.72±5.54) ng/mL of the control group; the levels of substance P and cortisol in the observation group were (35.82±4.47) ng/L and (75.64±8.02) μg/L, respectively, both lower than (48.14±5.32) ng/L and (94.53±10.78) μg/L of the control group, and the differences were statistically significant (all P <0.05). Conclusion The guided self help intervention based on DBT is helpful for reducing NSSI behavior among college students.

Sinopodophyllum hexandruma is a traditional Chinese medicine in China,which is mostly distributed in Gansu,Shaanxi,Sichuan,Qinghai,Yunnan and Xizang,etc.In recent years,with the gradual deepening of the research on the chemical composition and pharmacology-toxicology of Sinopodophyllum hexandruma,its antitumour and antiviral pharmacodynamic evaluation has increasingly become a research hotspot in the industry.Based on the chemical structure,pharmacological properties and the theoretical basis of quality markers(Q-markers),this paper presents an in-depth literature review and analysis of the chemical composition,pharmacological activities and Q-markers of Sinopodophyllum hexandruma,and systematically explores and predicts the Q-markers of Sinopodophyllum hexandruma.It is proposed that Podophyllotoxin,picropodophyllotoxin,podophyllotoxinone,quercetin,kaempferol,quercetin-3-O-β-glucoside can be used as the Q-marker of Sinopodophyllum hexandruma.In the later stage,these index components can be selected to control the whole quality of Sinopodophyllum hexandrum,and provide some data support and theoretical reference for the quality evaluation of Sinopodophyllum hexandrum.

Objective:To analyze the changes of DNA methylation in peripheral blood mononuclear cells (PBMC) of patients with hepatocellular carcinoma (HCC) and to evaluate the clinical value of a combined model based on FSIP1 gene methylation on the early diagnosis of HCC.Methods:This is a case-control study. From May 2023 to September 2024, 183 HCC patients and 155 healthy controls were collected in Qilu Hospital of Shandong University. The selected study subjects were divided into three cohorts: 14 HCC patients and 39 healthy controls formed the discovery cohort, a screening cohort consisted of 36 HCC patients and 39 healthy controls, 133 HCC patients and 77 healthy controls were included in the model construction cohort. 935k methylation chip analysis was used to identify specific differentially methylated sites in peripheral blood PBMC of the discovery cohort. The absolute value of the average methylation level difference between HCC group and healthy control group (|Δβ|) and P value were calculated. Then targeted bisulfite sequencing was used to verify the differentially methylated sites in the screening cohort. Finally, based on MethylTarget methylation sequencing technology, differential methylation sites were further verified in model construction cohort (divided into training set and validation set, training set consisted of 99 HCC patients and 57 healthy controls; validation set consisted of 34 HCC patients and 20 healthy controls). HCC early diagnosis model was constructed by random forest algorithm combined with clinical parameters and the diagnostic performance of the model was evaluated by receiver operating characteristic (ROC) curve in the validation set. Results:The total of 7 249 differentially methylated sites between HCC patients and healthy controls in discovery cohort were selected under the rule of |Δβ|≥0.06 and P<0.01. Among them, the cg02155073 site located on FSIP1 was hypermethylated in PBMC of HCC patients in the screening cohort and model cohort ( P<0.001). The AUC of HCC early diagnosis model (FmAP) based on FSIPI in the validation set was 0.967 (95% CI 0.924-1.000); sensitivity was 88%, specificity was 95%. The model had good diagnostic efficacy for patients with early HCC, stage Ⅰ-Ⅱ HCC AUC was 0.958 (95% CI 0.898-1.000). The FmAP model also had diagnostic value for tumor size <2 cm HCC and AFP negative HCC, with AUC of 0.955 (95% CI 0.898-1.000) and 0.964 (95% CI 0.934-0.994).The sensitivity were 92% and 93% and specificity both were 84%. Conclusion:The FmAP model based on FSIP1 gene methylation has good clinical value for the early diagnosis of hepatocellular carcinoma.

Objective:To study the clinical features and risk factors of prognosis of neonatal appendicitis.Methods:From January 2014 to December 2022, all infants with neonatal appendicitis and received surgery in our hospital were retrospectively analyzed.Results:A total of 6 cases were enrolled, including 1 boy and 5 girls, with gestational age 36-40 weeks, birth weight 1 990~3 300 g, age of admission 5-11 d and time from illness onset to admission 0.5-4 d. All infants had abdominal distension, combined with vomiting in 4 cases, fever in 3 cases and blood in stool in 1 case. Gastrointestinal perforation was found on preoperative abdominal X-ray in 5 cases. All 6 cases received surgery and confirmed the diagnosis of appendicitis with perforation during the surgery. Appendectomy was performed without mortality. 1 case had Amyand hernia and received high ligation of the hernia sac during operation. 1 case had meningitis and was cured after 3 weeks of antibiotic treatment. 1 case developed adhesive intestinal obstruction 3 months after surgery and underwent intestinal adhesiolysis. One case developed colonic stenosis one month after surgery. The stenotic segment of the colon was resected and primary intestinal anastomosis was performed.Conclusions:Neonatal appendicitis progresses rapidly and is difficult to diagnose. The possibility of appendicitis with perforation should be considered when preoperative abdominal X-ray suggesting pneumoperitoneum. Intraoperatively, it is necessary to pay attention to the relationship between appendiceal perforation and other lesions for comprehensive treatment, and change the surgical approach accordingly.

Objective:To investigate the current situations and development requirements of emergency testing among secondary and tertiary hospitals in China.Methods:The data were collected from secondary and tertiary hospitals via online questionnaire across 31 provinces in China from February 1 to March 1, 2021. The questionnaire involves various aspects of emergency testing, including area of emergency laboratory, staffs and equipment configuration, inspection items, Turn-around time (TAT), reagents and consumables management, pre-analysis quality control, laboratory information system, critical values management and biosafety, etc.Results:A total of 2 187 questionnaires were obtained, and 1 503 valid questionnaires from 755 secondary hospitals and 748 tertiary hospitals were finally analyzed. The research data showed that daily average number of patients visiting emergency department exceeding 300 person-time in 29.41% (220/748) tertiary hospitals, but that number was less than 100 person-time in 76.69% (579/755) secondary hospitals; daily average emergency tests exceeding 5 000 was reported in 24.47% (183/748) tertiary hospitals, and less than 2 000 was reported in 93.51% (706/755) secondary hospitals; the area of emergency laboratory was less than 100 m 2 in 68.79% (238/346) tertiary hospitals with independent emergency testing laboratory; there were no fixed staffs of emergency testing in 56.02% (842/1 503) hospitals; the biochemical/immunoassay analyzer in 8.65% (130/1 503) hospitals did not have STAT position; one hundred and twenty-six hospitals (8.38%) did not have stock in and stock out record for reagents and consumes materials; the conventional statistical analysis of unqualified specimen was not carried out in 24.62% (370/1 503) hospitals; priority on emergent specimen was not set in 58.62% (881/1 503) hospitals; whole process monitoring function was not equipped in 48.64% (731/1 503) hospitals; there was no conventional communication working mechanism with clinicians on critical value in 7.32% (110/1 503) hospitals; overall, 50.23% (755/1 503) participants did not consider that biosafety risks exist in their emergency testing laboratory. Conclusions:This survey objectively presents the current situations and future development requirements of emergency testing among secondary and tertiary hospitals in China. The survey also reflects that some important process and concepts need to be improved, and extensive attention should be paid by laboratory and hospital administrator, in the area such as communication with clinician, site construction and staff configuration, administration on the priority of emergency testing, administration on the reagent and consumable materials, laboratory informatization construction, laboratory biosafety, and so on.