Objective: To investigate the clinicopathological characteristics and diagnostic-therapeutic strategies of oncocytic mucoepidermoid carcinoma (OMEC) of the parotid gland, and to enhance awareness of this rare variant among clinicians and pathologists. Methods: The clinical data, imaging findings, histopathological features, immunophenotype, and molecular characteristics of two patients with parotid OMEC were retrospectively analyzed, and the relevant literature was reviewed. Results: Case 1 was a 50-year-old man who presented with a painless mass behind the right earlobe for more than 2 years. The patient underwent extended parotidectomy with preservation of the facial nerve. Histopathological examination revealed that the tumor was predominantly composed of oncocytic cells with a small proportion of mucous cells. Immunohistochemically, the tumor cells were partially positive for cytokeratin 5/6, cytokeratin 7, and P63. Special staining with alcian blue, periodic acid-Schiff, and phosphotungstic acid hematoxylin yielded positive results. The diagnosis of right parotid OMEC was established. No recurrence or metastasis was observed during a 1 year follow-up. Case 2 was a 61-year-old man with a 3-month history of a mass beneath the left ear. After partial parotidectomy at an outside institution, pathological consultation at the Stomatological Hospital of Jilin University demonstrated that the tumor consisted almost entirely of oncocytic cells, exhibited infiltrative growth, and lacked typical mucous, epidermoid, and intermediate cells. Fluorescence in situ hybridization confirmed positive mastermind-like transcriptional activator 2 (MAML2) gene rearrangement, establishing the diagnosis of left parotid OMEC. The patient subsequently underwent total parotidectomy with preservation of the facial nerve, and no recurrence was detected during a short-term 3 months follow-up. A review of the literature indicated that OMEC most commonly arises in the parotid gland and is generally a low-grade malignancy with favorable prognosis. When tumors are composed exclusively of oncocytic cells, exhibit minimal cytological atypia, and lack the classical cellular components of mucoepidermoid carcinoma, they are highly prone to misdiagnosis as oncocytoma, nodular oncocytic hyperplasia, or other benign oncocytic lesions. Accurate differential diagnosis relies on recognition of infiltrative growth patterns, supportive immunophenotypic markers (e.g., P63 positivity), and detection of characteristic MAML2 gene rearrangement. Complete surgical excision remains the treatment of choice. Conclusion OMEC dominated by oncocytic cells carries a high risk of clinical misdiagnosis. Integrating the assessment Conclusion OMEC dominated by oncocytic cells carries a high risk of clinical misdiagnosis. Integrating the assessment of infiltrative histopathological features with immunohistochemistry and molecular detection of MAML2 rearrangement is crucial for accurate diagnosis, appropriate assessment of tumor behavior, and optimal surgical decision making.

This paper systematically elaborates on the key points of diagnosis and differential diagnosis of salivary gland tumors characterized by a substantial amount of extracellular mucus as a main or prominent feature, and clarifies the core differential features. The term "mucus-rich" specifically denotes that mucus is a major component of the tumor, rather than a focal or minor one. This phenomenon is associated with distinct histogenetic mechanisms: it may result from specific genetic mutations (e.g., AKT1 E17K in mucinous adenocarcinoma) that drive ductal epithelial differentiation into mucus-secreting cells, or from myoepithelial cells secreting glycosaminoglycans that form a myxoid stroma. Salivary gland tumors with abundant extracellular mucus include mucinous cystadenoma, sialadenoma papilliferum-like intraductal papillary tumors, mucinous myoepithelioma, pleomorphic adenoma with mucin-rich stroma, mucinous adenocarcinoma, low-grade mucoepidermoid carcinoma, mucin-rich salivary duct carcinoma and intestinal-type adenocarcinoma. The diagnosis of these tumors is complicated by the dual nature of extracellular mucus: while it is a defining feature of some entities, it can also obscure key diagnostic architectural features in others, leading to histological overlap and inconspicuous diagnostic areas. Given the frequent histological morphological overlap among these tumors, immunohistochemical findings and molecular characteristics have emerged as crucial differential diagnostic criteria. Core differential diagnostic points include the following: histologically, there must be meticulous identification of typical structures obscured by mucin (such as squamoid cells in mucoepidermoid carcinoma and apocrine features in salivary duct carcinoma); in immunohistochemical staining, CK20 is useful for distinguishing intestinal-type adenocarcinoma (positive) from mucinous adenocarcinoma (negative), while androgen receptor aids in differentiating salivary duct carcinoma (positive) from mucoepidermoid carcinoma (negative); and molecular testing plays a critical role in definitive diagnosis (e.g., the AKT1 E17K mutation for mucinous adenocarcinoma, MAML2 rearrangement for mucoepidermoid carcinoma, and MEF2C::SS18 fusion for microsecretory adenocarcinoma). This paper systematically summarizes the core pathological features and differential diagnostic points of mucin-rich salivary gland tumors, aiming to provide a practical reference for clinical pathological diagnosis.

Objective To systematically evaluate the effect of hysteroscopic uterine septum resection on the pregnancy live birth rate in patients with septate uterus.Methods The randomized controlled studies and cohort studies on the impact of hysteroscopic uterine septum resection on the pregnancy live birth rate in the patients with septate uterus were retrieved from PubMed,Web of Science,CNCN.cn,and Wanfang databases.The retrieval time was from the establishment of the database to March 2024.The NOS scale was used to con-duct the literature quality evaluation.The Statal0.0 statistical software was used for conducting the meta a-nalysis,and the main evaluation index was the pregnancy live birth rate.Results A total of 9 articles on the treatment of septate uterine were included,involving 821 subjects,including 528 septate uterine patients with hysteroscopic uterine septum resection and 293 septate uterine patients with conservative treatment.The meta analysis showed that the live birth rate in the patients with septate uterine undergoing hysteroscopic uterine septum resection was higher than that in the patients with septate uterine undergoing the conservative treat-ment(I2=38.0％,OR=1.60,95％CI:1.05-2.44,P=0.028).Conclusion Hysteroscopic uterine septum resection could improve the pregnancy outcome and increase the live birth rate.It is a minimally invasive sur-gery with good effect and high safety,which has good clinical application prospects and is worth popularizing.

Under the trend of increasing aging， integrated elderly care and medical services is an important measure to optimize the supply of elderly care services and promote the good death of the elderly. Using the cooperative production theory and the classical grounded theory， a qualitative analysis was conducted on 38 cases of elderly palliative care and 25 cases of hospital-based palliative care under the integrated elderly care and medical services model from a hospital in Nanning City using Nvivo 20.0 software. This paper found that the integrated elderly care and medical services mode emphasized the deep integration of medical and elderly care services by integrating resources and improving service efficiency， to achieve the basic experience of comprehensive health care for the elderly. The promotion of these experiences has a positive significance for building a multi-agent cooperative production system， strengthening personnel training， perfecting the performance distribution mechanism， and further promoting the development of the national palliative care pilot.

Objective:In order to effectively educate students on tooth defect diseases and restoration techniques, the teaching and research team at the School of Stomatology of Qingdao University developed an integrated course operative dentistry. This course is specifically designed to align with the undergraduate curriculum reform requirements of "Three Early, Two Multiple and One Integration".Methods:The teaching practice of operative dentistry was conducted with the stomatology undergraduates of grade 2020 and 2021. The course group redesigned the curriculum by reorganizing teaching content, rebuilding teaching resources, reconstructing teaching mode, and reshaping the evaluation system. Evaluation of the curriculum design included test scores, satisfaction questionnaires, and teacher self-evaluation. Statistical analysis was performed using SPSS 27.0 software, including independent sample t-tests for numerical variables and Fisher's exact test or Wilcoxon rank sum test for categorical variables. Results:Through the integrated course learning, 92.68% (38/41) of the students of grade 2020 and 97.44% (38/39) of the students of grade 2021 can basically or completely master various dental defect repair schemes and understand the importance of preserving natural tooth. 82.93% (34/41) of the students of grade 2020 and 100.00% (39/39) of the students of grade 2021 could basically or completely master the key points of various dental defect restorations.Conclusions:Through the practice of teaching, it has been confirmed that the integrated course of operative dentistry is beneficial to students' mastering the knowledge and skills of dental defect diseases and their restoration in a more comprehensive way, and is conducive to the cultivation of clinical thinking, hands-on ability and the patient-centered, comprehensive problem-solving thinking, which is in line with the guidance on the innovation and development of medical education.

Objective:In order to effectively educate students on tooth defect diseases and restoration techniques, the teaching and research team at the School of Stomatology of Qingdao University developed an integrated course operative dentistry. This course is specifically designed to align with the undergraduate curriculum reform requirements of "Three Early, Two Multiple and One Integration".Methods:The teaching practice of operative dentistry was conducted with the stomatology undergraduates of grade 2020 and 2021. The course group redesigned the curriculum by reorganizing teaching content, rebuilding teaching resources, reconstructing teaching mode, and reshaping the evaluation system. Evaluation of the curriculum design included test scores, satisfaction questionnaires, and teacher self-evaluation. Statistical analysis was performed using SPSS 27.0 software, including independent sample t-tests for numerical variables and Fisher's exact test or Wilcoxon rank sum test for categorical variables. Results:Through the integrated course learning, 92.68% (38/41) of the students of grade 2020 and 97.44% (38/39) of the students of grade 2021 can basically or completely master various dental defect repair schemes and understand the importance of preserving natural tooth. 82.93% (34/41) of the students of grade 2020 and 100.00% (39/39) of the students of grade 2021 could basically or completely master the key points of various dental defect restorations.Conclusions:Through the practice of teaching, it has been confirmed that the integrated course of operative dentistry is beneficial to students' mastering the knowledge and skills of dental defect diseases and their restoration in a more comprehensive way, and is conducive to the cultivation of clinical thinking, hands-on ability and the patient-centered, comprehensive problem-solving thinking, which is in line with the guidance on the innovation and development of medical education.

Objective To explore the effects of deletion of protein 4.1R on hepatocyte proliferation,apoptosis,and glycolysis and the molecular mechanisms.Methods A 4.1R-/-HL-7702 cell line was constructed using CRISPR/Cas9 technique,and with 4.1R+/+HL-7702 cells as the control,its proliferative capacity and cell apoptosis were assessed using CCK-8 assay,EdU-488 staining,flow cytometry and Annexin V-FITC/PI staining at 24,48,72 h of cell culture.The changes in glucose uptake,lactate secretion,ATP production and pH value of the culture supernatant of 4.1R-/-HL-7702 cells were determined.The mRNA expressions of the key regulatory enzymes HK2,PFKL,PKM2 and LDHA in glycolysis were detected with qRT-PCR,and the protein expressions of AMPK,p-AMPK,Raptor and p-Raptor were determined using Western blotting.Results Western blotting and sequencing analysis both confirmed the successful construction of 4.1R-/-HL-7702 cell line.Compared with the wild-type cells,4.1R-/-HL-7702 cells exhibited a lowered proliferative activity with increased cell apoptosis.The deletion of protein 4.1R also resulted in significantly decreased glucose uptake,lactate secretion and ATP production of the cells and increased pH value of the cell culture supernatant.qRT-PCR showed significantly decreased mRNA expressions of the key regulatory enzymes in glycolysis in 4.1R-/-HL-7702 cells.Compared with those in HL-7702 cells,the expression levels of AMPK and Raptor proteins were decreased while the expression levels of p-AMPK and p-Raptor proteins increased significantly in 4.1R-/-HL-7702 cells.Conclusion Deletion of protein 4.1R in HL-7702 cells results in reduced proliferative capacity,increased apoptosis and suppression of glycolysis,and this regulatory mechanism is closely related with the activation of the downstream AMPK-mTORC1 signaling pathway.

Objective To explore the effects of deletion of protein 4.1R on hepatocyte proliferation,apoptosis,and glycolysis and the molecular mechanisms.Methods A 4.1R-/-HL-7702 cell line was constructed using CRISPR/Cas9 technique,and with 4.1R+/+HL-7702 cells as the control,its proliferative capacity and cell apoptosis were assessed using CCK-8 assay,EdU-488 staining,flow cytometry and Annexin V-FITC/PI staining at 24,48,72 h of cell culture.The changes in glucose uptake,lactate secretion,ATP production and pH value of the culture supernatant of 4.1R-/-HL-7702 cells were determined.The mRNA expressions of the key regulatory enzymes HK2,PFKL,PKM2 and LDHA in glycolysis were detected with qRT-PCR,and the protein expressions of AMPK,p-AMPK,Raptor and p-Raptor were determined using Western blotting.Results Western blotting and sequencing analysis both confirmed the successful construction of 4.1R-/-HL-7702 cell line.Compared with the wild-type cells,4.1R-/-HL-7702 cells exhibited a lowered proliferative activity with increased cell apoptosis.The deletion of protein 4.1R also resulted in significantly decreased glucose uptake,lactate secretion and ATP production of the cells and increased pH value of the cell culture supernatant.qRT-PCR showed significantly decreased mRNA expressions of the key regulatory enzymes in glycolysis in 4.1R-/-HL-7702 cells.Compared with those in HL-7702 cells,the expression levels of AMPK and Raptor proteins were decreased while the expression levels of p-AMPK and p-Raptor proteins increased significantly in 4.1R-/-HL-7702 cells.Conclusion Deletion of protein 4.1R in HL-7702 cells results in reduced proliferative capacity,increased apoptosis and suppression of glycolysis,and this regulatory mechanism is closely related with the activation of the downstream AMPK-mTORC1 signaling pathway.

Objective:To evaluate the effect of goal-oriented online and offline mixed teaching method on the trainees of burn operating room.Methods:From June 2019 to June 2020, 42 trainees of burn operating room in our hospital were selected for the randomized parallel trial, and they were randomly divided into two groups, routine group and research group. The routine group adopted the conventional online and offline mixed teaching method, while the research group adopted the goal-oriented online and offline mixed teaching method. The internship time of both group lasted for 1 month. Results and excellent rates, self-confidence and burn surgery skills evaluation before and after the internship, and satisfaction with the internship mode were compared between the two groups. SPSS 19.0 was used for t test and chi-square test. Results:The results and excellent and good rates of theoretical examination and practical examination in the research group were higher than those of the routine group. The scores of self-confidence, choice of operation mode, innovation and optimization of operation, control of operation complications and treatment of intraoperative emergencies in the two groups after internship were higher than those before internship, and the above scores of research group were higher than those of the routine group after internship. The satisfaction scores of the students on enhancing self-confidence, and improving operational ability, learning initiative and learning efficiency in the research group were significantly higher than those in the routine group ( P < 0.05). Conclusion:Goal-oriented online and offline mixed teaching method on trainees in burn operating room can not only improve the examination results, enhance their confidence and burn surgery skills, but also achieve their satisfaction.

Objective: To determine the changes of serum Tau protein, glial fibrillary acidic protein (GFAP), tumor necrosis factor alpha (TNF-α), and malonaldehyde (MDA) in rats after blast-related traumatic brain injury (BTBI) and to provide relative information for further studies on BTBI mechanism and seek specific biomarkers for BTBI.
Methods: Ninety male Sprague-Dawley rats were randomly assigned into three groups: control group, moderate blast injury group, and severe blast injury group (n=30 for each). Rats in the moderate and severe blast injury groups were respectively exposed to corresponding levels of BTBI. After explosion, serum levels of Tau, GFAP, TNF-α, and MDA in each group were determined by Elisa assay at different time points after injury (8 h, 24 h, 3 d, and 6 d). The extent of brain damage was detected by Nissl staining and TUNEL assay.
Results: Serum levels of Tau and GFAP rapidly increased and reached the peak at 24 h after either moderate or severe blast injury. All the values were significantly higher than control group at all time points (P<0.05). Serum TNF-α level of both injury groups peaked at 8 h after BTBI and stayed significantly higher than control group at all time points (P<0.05). Serum MDA of two injury groups began to significantly increase at 3 d and the level stayed significantly higher than control group until 6 d (P<0.05). Moreover, unlike the other biomarkers, serum MDA of severe blast injury group was significantly higher than moderate blast injury group at 6 d (P<0.05).
Conclusion: The changes of serum Tau, GFAP, and TNF-αshowed a good sensitivity at the acute phase after BTBI (within 24 h). However, their specificity and correlation with the extent of injury were limited in this experiment. Moreover, although the change of serum MDA showed a poor sensitivity and specificity to the diagnosis of BTBI during the first few days, it can reflect the injury degree at 6 d after injury. Therefore, further studies are needed to improve the methods of detecting more serum markers and investigate the significance of multiple markers in diagnosing BTBI.