Liver fibrosis is the common pathological process in the progression of various chronic liver diseases to liver cirrhosis， and it greatly affects the prognosis of patients with chronic liver diseases. As a novel adipokine， Chemerin participates in the metabolism of glucose and lipids and inflammation， and various studies have shown that the expression level of Chemerin is correlated with the degree of liver fibrosis， suggesting that Chemerin may be involved in the process of liver fibrosis by regulating metabolism and inflammation. Chemerin has shown certain potential in the auxiliary diagnosis of liver fibrosis and the intervention against the progression of liver fibrosis. This article reviews the potential role and mechanism of action of Chemerin in the process of liver fibrosis， in order to provide new ideas for the diagnosis and treatment of liver fibrosis.

Reninoma is a rare renal secretory tumor，prevalent in the young population. This disease is mostly surgically resected，and the use of microwave ablation to treat reninoma in children is scarce. A case of reninoma in a child was reported in this paper. The patient presented with refractory hypertension，hypokalemia，hyperreninemia and hyperaldosteronemia. Enhanced CT and contrast-enhanced ultrasound showed mass in the lower pole of the right kidney，which was considered as reninoma and microwave ablation was performed. The renin concentration decreased to 68.42 pg/ml at 4 hours after surgery. After 1 year of postoperative follow-up，there was no recurrence of hypertension and hypokalemia，and no signs of tumor recurrence were seen on repeated ultrasound examinations.

Objective To investigate the expression levels of T cell receptor(TCR)ζchain and Zeta-chain-associated protein kinase 70(ZAP70)in peripheral blood of patients with primary Sj?gren syndrome(PSS).Methods Thirty-six patients with PSS who were treated at Jiujiang NO.1 People's Hospital from January to June 2024 were enrolled in observation group,and 30 healthy subjects during the same period were enrolled in control group.Real-time fluorescent quantitative polymerase chain reaction was used to detect the expression levels of TCRζ chain and ZAP70 in peripheral blood mononuclear cells,and flow cytometry was used to detect peripheral blood T cell subsets.Pearson correlation was used to analyze the correlation between TCRζ chain,ZAP70 and other detection indicators.Results The relative expression levels of TCRζ chain and ZAP70 in observation group were significantly lower than those in control group(P＜0.05),while CD8+and interleukin-6(IL-6)were significantly higher than those in control group(P＜0.05).Pearson correlation analysis showed that TCRζ chain was positively correlated with CD4+,and negatively correlated with CD8+and IL-6(P＜0.05).ZAP70 was negatively correlated with CD8+and IL-6(P＜0.05).Conclusion The expressions of TCRζ chain and ZAP70 are down-regulated in PSS patients,which may exacerbate the immune disorder of PSS through abnormal T cell signal transduction.

Postoperative infection of internal fixation of closed fractures the lower limbs in adults represents a devastating complication, characterized by diagnostic challenges, prolonged treatment duration and high disability rates. Current management of these infections faces multiple challenges, such as difficulties in early accurate diagnosis, and various controversies about the treatment plan, leading to poor overall diagnosis and treatment results. To address these issues, based on evidence-based medicine and principles with emphasis on scientific rigor, clinical applicability and innovation, the Trauma Branch of the Chinese Medical Association, Orthopedic Branch of the Chinese Medical Doctor Association, Orthopedics Branch of the Chinese Medical Association, and Trauma Orthopedics and Polytrauma Group of the Resuscitation and Emergency Committee of the Chinese Medical Doctor Association have collaboratively organized a panel of relevant experts to develop the Guideline for diagnosis and treatment of infection after internal fixation of closed lower limb fractures in adults ( version 2025). The guideline proposed 10 recommendations, aiming to provide a foundation for standardized diagnosis and treatment of postoperative infection in adults with closed lower limb fractures.

Objective To explore the application value of shear wave elastography(SWE)in non-invasive quantitative assessment of non-alcoholic fatty liver disease(NAFLD)in children,and provide diagnostic clues for early clinical intervention in children with NAFLD.Methods A total of 362 children voluntarily examined in Inner Mongolia Maternal and Child Health Hospital from February 2022 to June 2023 were selected as the study objects,and were divided into NAFLD group(216 cases)and control group(146 cases)according to the examination results.The age,sex,body mass index(BMI),alanine aminotransferase(ALT),y-glutamyl transferase(γ-GGT),uric acid,total cholesterol(TC),triglyceride(TG),low density lipoprotein(LDL),insulin,high density lipoprotein(HDL),glucose,aspartate aminotransferase of two groups of children were collected and compared.Spearman rank correlation was used for correlation analysis.Receiver operating characteristic(ROC)curve was used to determine the predictive value of Young's modulus to NAFLD.Results BMI,liver Young's modulus,portal flow velocity,ALT,y-GGT,uric acid,TC,TG,LDL and insulin in NAFLD group were significantly higher than those in control group,while HDL was significantly lower than that in control group(P＜0.05).Liver Young's modulus was positively correlated with portal flow velocity,BMI,ALT,y-GGT,uric acid,TC,TG,LDL and insulin,and negatively correlated with HDL(P＜0.05).ROC curve results showed that the area under the curve of liver Young's modulus predicted NAFLD in children was 0.873(95％CI:0.836-0.910),sensitivity was 75.0％,specificity was 93.2％.Conclusion SWE can evaluate NAFLD non-invasively,real-time and quantitatively,and provide important clinical diagnostic information for early intervention and treatment of children with NAFLD.

Objective:To build an experimental curriculum system of Oral Preventive Medicine with the goal of improving the job competence of oral medical students.Methods:By establishing knowledge modules, adjusting the experimental content, integrating teaching methods, and improving the comprehensive assessment system of teaching, the teaching reform is carried out in the experimental teaching of Oral Preventive Medicine for undergraduates from 2016 to 2017 in the Department of Stomatology at Zhuhai Campus of Zunyi Medical University.Results:The experimental curriculum system and teaching evaluation system of Oral Preventive Medicine with the goal of improving the job competence of medical students have been established. Cultivate students' independent learning ability and innovative and practical spirit, guide undergraduates to participate in social services, enhance the sense of social responsibility, and integrate theoretical education, ability training and quality education.Conclusions:Explore the new model of experimental oral medicine teaching, initially build the experimental curriculum system of Oral Preventive Medicine with the goal of job competence, promote the transformation of undergraduate teaching concept, deepen the connotation of teaching, and improve the depth and breadth of the teaching of Oral Preventive Medicine.

Objective To explore the identification method,pathogenesis,clinical characteristics and individualized pharmacotherapy of asymptomatic hyperuricemia after renal transplantation.Methods The pharmacist was on duty at the organ transplant outpatient clinic.During this time,they analyzed and sorted out the medications,identified and differentiated a case of asymptomatic hyperuricemia related to spironolactone in a patient who had undergone a renal transplant,and provided comprehensive care throughout the entire process.Results The asymptomatic hyperuricemia in this patient might be associated with spironolactone,and the adverse reactions of the patient were alleviated by pharmacists through optimizing clinical treatment.Up to now,no hyperuricemia occurred.Conclusions Pharmacists are required to collaborate closely with clinicians to establish medication profiles for patients under long-term follow-up and to closely monitor and evaluate drug-related adverse reactions.Additionally,they should assess the renal function and immune status of transplant recipients promptly and formulate individualized treatment plans in order to enhance the long-term survival of both the transplanted kidneys and the recipients.

Objective To explore the identification method,pathogenesis,clinical characteristics and individualized pharmacotherapy of asymptomatic hyperuricemia after renal transplantation.Methods The pharmacist was on duty at the organ transplant outpatient clinic.During this time,they analyzed and sorted out the medications,identified and differentiated a case of asymptomatic hyperuricemia related to spironolactone in a patient who had undergone a renal transplant,and provided comprehensive care throughout the entire process.Results The asymptomatic hyperuricemia in this patient might be associated with spironolactone,and the adverse reactions of the patient were alleviated by pharmacists through optimizing clinical treatment.Up to now,no hyperuricemia occurred.Conclusions Pharmacists are required to collaborate closely with clinicians to establish medication profiles for patients under long-term follow-up and to closely monitor and evaluate drug-related adverse reactions.Additionally,they should assess the renal function and immune status of transplant recipients promptly and formulate individualized treatment plans in order to enhance the long-term survival of both the transplanted kidneys and the recipients.

Objective:To build an experimental curriculum system of Oral Preventive Medicine with the goal of improving the job competence of oral medical students.Methods:By establishing knowledge modules, adjusting the experimental content, integrating teaching methods, and improving the comprehensive assessment system of teaching, the teaching reform is carried out in the experimental teaching of Oral Preventive Medicine for undergraduates from 2016 to 2017 in the Department of Stomatology at Zhuhai Campus of Zunyi Medical University.Results:The experimental curriculum system and teaching evaluation system of Oral Preventive Medicine with the goal of improving the job competence of medical students have been established. Cultivate students' independent learning ability and innovative and practical spirit, guide undergraduates to participate in social services, enhance the sense of social responsibility, and integrate theoretical education, ability training and quality education.Conclusions:Explore the new model of experimental oral medicine teaching, initially build the experimental curriculum system of Oral Preventive Medicine with the goal of job competence, promote the transformation of undergraduate teaching concept, deepen the connotation of teaching, and improve the depth and breadth of the teaching of Oral Preventive Medicine.

Objective To explore the application value of shear wave elastography(SWE)in non-invasive quantitative assessment of non-alcoholic fatty liver disease(NAFLD)in children,and provide diagnostic clues for early clinical intervention in children with NAFLD.Methods A total of 362 children voluntarily examined in Inner Mongolia Maternal and Child Health Hospital from February 2022 to June 2023 were selected as the study objects,and were divided into NAFLD group(216 cases)and control group(146 cases)according to the examination results.The age,sex,body mass index(BMI),alanine aminotransferase(ALT),y-glutamyl transferase(γ-GGT),uric acid,total cholesterol(TC),triglyceride(TG),low density lipoprotein(LDL),insulin,high density lipoprotein(HDL),glucose,aspartate aminotransferase of two groups of children were collected and compared.Spearman rank correlation was used for correlation analysis.Receiver operating characteristic(ROC)curve was used to determine the predictive value of Young's modulus to NAFLD.Results BMI,liver Young's modulus,portal flow velocity,ALT,y-GGT,uric acid,TC,TG,LDL and insulin in NAFLD group were significantly higher than those in control group,while HDL was significantly lower than that in control group(P＜0.05).Liver Young's modulus was positively correlated with portal flow velocity,BMI,ALT,y-GGT,uric acid,TC,TG,LDL and insulin,and negatively correlated with HDL(P＜0.05).ROC curve results showed that the area under the curve of liver Young's modulus predicted NAFLD in children was 0.873(95％CI:0.836-0.910),sensitivity was 75.0％,specificity was 93.2％.Conclusion SWE can evaluate NAFLD non-invasively,real-time and quantitatively,and provide important clinical diagnostic information for early intervention and treatment of children with NAFLD.