Cholestatic liver disease(CLD)is a liver condition caused by disorders in bile acid secretion and metabolism due to various reasons,and it has the common pathological features of various chronic liver diseases.In recent years,the role of cholangiocyte senescence(CS)in the pathogenesis of CLD has attracted more and more attention,and CS not only participates in the development and progression of CLD,but it is also significantly associated with the course and prognosis of the disease.Targeted clearance of senescent cholangiocytes or blocking senescence-related pathways can improve CLD.This article summarizes the role of CS in CLD,related influencing factors,and the research advances in CLD,in order to provide a theoretical reference for subsequent studies on CLD.

Cholestatic liver disease(CLD)is a liver condition caused by disorders in bile acid secretion and metabolism due to various reasons,and it has the common pathological features of various chronic liver diseases.In recent years,the role of cholangiocyte senescence(CS)in the pathogenesis of CLD has attracted more and more attention,and CS not only participates in the development and progression of CLD,but it is also significantly associated with the course and prognosis of the disease.Targeted clearance of senescent cholangiocytes or blocking senescence-related pathways can improve CLD.This article summarizes the role of CS in CLD,related influencing factors,and the research advances in CLD,in order to provide a theoretical reference for subsequent studies on CLD.

Neck dissection(ND)is one of the main treatment methods for oral and maxillofacial malignancies.Although ND type is in con-stant improvement,but intraoperative peal-pull-push injury of the accessory nerve,muscle,muscle membrane,fascia and ligament induced shoulder syndrome(SS)is still a common postoperative complication,combined with the influence of radiochemotherapy,not only can cause pain,stiffness,numbness,limited dysfunction of shoulder neck and arm,but also may have serious impact on patient's life quality and phys-ical and mental health.At present,there is still a lack of a systematic evaluation and rehabilitation management program for postoperative SS of oral and maxillofacial malignant tumors.Based on the previous clinical practice and the current available evidence,refer to the relevant lit-erature at home and abroad,the experts in the field of maxillofacial tumor surgery and rehabilitation were invited to discuss,modify and reach a consenusus on the etiology,assessment diagnosis,differential diagnosis,rehabilitation strategy and prevention of SS,in order to provide clinical reference.

Objective To explore the impact of different times for endovascular embolization thera-py on the prognosis of elderly patients with intracranial aneurysm(IA)rupture and bleeding.Methods Clinical data of 156 elderly patients with IA rupture and bleeding admitted to our hos-pital from January 2019 to December 2022 were collected and analyzed retrospectively.All of them underwent intravascular embolization treatment.According to the timing of intravascular emboli-zation,they were divided into super early group(within 24 h from onset,n=66)and delayed group(in 24 h after onset,n=90).The Hunt-Hess grade,aneurysm location,cerebrospinal fluid exchange,embolization situation and success rate of embolization treatment were observed and re-corded.The prognosis of the two groups were evaluated with NIHSS score and mRS score.Results In terms of prognosis,no significant differences were observed in cerebrovascular spasm,disorders of consciousness,limb movement disorder,proportion of re-bleeding,and mRS score between the two groups(P＞0.05).The ratio of hydrocephalus was obviously lower in the super early group than the delayed group(4.55％vs 15.56％,P＜0.05).Though no statistical difference was seen in the pre-operative NIHSS score between the two groups(P＞0.05),the score was declined after treatment(P＜0.05),with that of the super early group notably lower than that in the delayed group(6.62±1.25 vs 7.82±1.35,P＜0.01).Conclusion Super early endovascular embolization can effectively reduce the incidence of hydrocephalus and improve neurological function in elderly patients with IA rupture and bleeding.

OBJECTIVE Aimed to analyze the demographic,anthropometric,severity,and common comorbidities of individuals with suspected obstructive sleep apnea(OSA)referred to the OSA diagnosis and treatment center of the Sixth People's Hospital affiliated with Shanghai Jiao Tong University School of Medicine from 2012 to 2021.METHODS Data of subjects with suspected OSA who underwent polysomnography(PSG)from January 2012 to December 2021 were collected.Subjects were categorized into five groups based on the PSG study date with a two-year interval.Clinical characteristics trends were compared across groups,focusing on the comparison between 2020-2021 and 2018-2019 to explore changes after COVID-19 epidemic.RESULTS 1.A total of 5870 subjects were included from 2012 to 2019[age(43.2±12.7)years,21.7％females].OSA prevalence was 84.8％.Over the two-year intervals,age,female proportion,OSA severity,and other indicators showed no significant changes.Body mass index(median 26.8kg/m2 to 26.0kg/m2)and overweight rates(78.1％to 73.4％)decreased yearly,as did the proportions of subjects who smoked(38.1％to 27.8％)and consumed alcohol(13.5％to 6.4％).The prevalence of hypertension increased yearly(40.3％to 51.8％),while awareness rates gradually decreased(70.3％to 59.4％).Diabetes prevalence remained relatively stable(9.4％to 9.7％),with increased awareness(49.5％to 66.2％).Dyslipidemia prevalence remained high(76.7％to 78.3％),with low awareness rates(20.8％to 28.7％).2.A total of 805 subjects were included from 2020 to 2021.Compared with 2018-2019,the proportion of females decreased(14.9％vs.22.0％),and OSA severity increased(apnea-hypopnea index 40.4 times/h vs.29.2 times/h).Prevalence rates of hypertension,diabetes,dyslipidemia(47.1％,6.9％,62.1％)and awareness rates(52.4％,57.7％,17.8％)were lower than those from 2018-2019.3.Compared with subjects with known their comorbidities,unknown subjects had significantly higher levels of systolic blood pressure(141 mmHg vs.134 mmHg),diastolic blood pressure(93 mmHg vs.85 mmHg),fasting blood glucose(7.87 mmol/L vs.6.07 mmol/L),and low-density lipoprotein(3.08 mmol/L vs.2.91 mmol/L)(P＜0.05).CONCLUSION From 2012 to 2021,individuals with suspected OSA referred for PSG test showed a tendency toward younger age,lower proportion of females,fewer comorbidities,but increased OSA severity.The awareness rate of comorbidities needs improvement,emphasizing the importance of a multidisciplinary approach to the diagnosis and treatment of OSA.

As a new technique ,CT spectral imaging can obtain two images of different energy level at same phase simultaneously ,then immediately rebuild high definition monoenergetic images ranging from 40 kV to 140 kV .It provides reliable data and information for early qualitative and quantitative diagnosis of diseases ,which possess huge potential in clinical and science research ;and more extensive developing space for developing of scientific research and clinical application .

Objective To investigate the clinical characteristics of diagnosis,treatment and prognosis of gastric cancer in elderly patients.Methods A total of 245 patients with gastric cancer in our hospital were retrospectively analyzed.Results Abdominal satiety and pain were the most common symptoms,which were higher in elderly group than in non elderly group (91.6％ vs.76.5％,P＜0.05).Tumors mostly located in cardia and fundus of the stomach in elderly group (47.9％) and in antrum in non-elderly group (54.4％).3.1％ of elderly patients had multi-original tumors,while tumors in non elderly patients were from single-original tumor.The incidences of comorbid chronic diseases were higher in elderly group than in non-elderly group.The surgery and radical operation (RO) resection rates were 80.0％ and 71.3 ％,which were similar in both groups.98.7％ of gastric cancer patients received chemotherapy.Although the proportion of patients who received three lines or more chemotherapy was lower in elderly group than in non-elderly patients,which did not reacha statistical difference (3.5％ vs.9.8％,x2=3.197,P＞0.05).Most elderly patients chose FOLFOX/XELOX chemotherapy regimen (75.4％) as compared with non-elderly patients.There was no significant difference in the median survival time between the elderly patients and the non-elderly patients (27.8 months vs.28.7 months,P＞0.05).Conclusions Most elderly patients with gastric cancer may present with abdominal satiety and pain at first.Tumors mostly locate in cardiac and fundus of the stomach and multi-original tumors are more common in elderly patients.Preoperative and postoperative complications are higher in elderly patients.Most elderly patients can receive surgery and chemotherapy.The surgery rate is similar in elderly and non-elderly groups.

Objective To develop simple theories and methods for health quality evaluation in moderately prosperous society, and to establish a health quality index (HQI) model to assess the improvement in health quality. Methods Four health quality - related indexes were selected following screening. HQI was then calculated. In 5 provinces, empirical analysis of HQI was conducted. Results In F test, there was significant difference in HQI between different regions of China in 2005. Conclusions The study provides a scientific, comprehensive, sensitive, and intuitive evaluation index, HQI, which may be helpful in assessing the health level.

Objective To address the expression correlation of ribosome-related genes in rat regeneration liver(RL) and those in liver tumor at transcriptional level.Methods Genes involved in ribosome biogenesis,assembly and function,as well as their expression changes in liver tumor,were obtained by online data collection and literature review,and their expression profiles in rat regenerating liver were detected by Rat Genome 230 2.0 array.Expression similarities and differences of the above genes were analyzed using statistical methods. Results A total of 75 genes were found to be RL-related.In regenerated liver and liver tumor,the expressions of 18 genes increased and 6 genes decreased,and no significant expression changes were found in 51 genes in liver tumor.Conclusion The expression profiles of the ribosome-related genes in regenerated liver cells and liver tumor cells have both similarities and differences,and the former exhibit properties of more gradualness and complexity.

Objective To study the expression changes of transcription factor genes and their underlying involvement in rat liver regeneration(LR) at transcription level. Methods The transcription factor genes and their function were collected by referring to the putative literatures and databases.Then,their expression in rat LR were checked by Rat Genome 230 2.0 array.LR-related genes were identified through the comparison of discrepancies in gene expression between partial hepatectomy(PH) and sham-operation(SO) groups. Results 320 genes were determined to be LR-related,which were involved in 16 biological processes,such as cellular metabolism,proliferation,differentiation,apoptosis,etc.Expression profiles of above genes were classified into 41 categories according to their functions and expression trends,implying their diversity and complexity during LR.The expression of transcription factor genes that were involved in carbohydrate biosynthesis,lipid metabolism,and inflammatory response was enhanced in the forepart(0.5-4 hours after PH) and prophase(6-12 hours after PH) of LR.Cellular proliferation,growth,differentiation and apoptosis related transcription factor genes were promoted in the metaphase(16-66 hours after PH) and anaphase(72-168 hours after PH).Conclusion Physiological and biochemical activities in LR were regulated by multiple transcription factor genes,and e2f1,fos,copeb,etc.played key roles in it.