OBJECTIVE To investigate the protective effects and potential mechanism of alisol B 23-acetate on acute alcoholic liver injury in mice. METHODS Fifty male Kunming mice were divided into the blank group， model group， and alisol B 23-acetate low-， medium- and high-dose groups （10， 20， 40 mg/kg）， with 10 mice in each group. Each group was given relevant drug solution or normal saline intragastrically， once a day， for 2 consecutive weeks. On the 15th day， mice in the blank group were given normal saline intragastrically， while the other four groups were given 12 mL/kg white wine intragastrically， twice at six-hour intervals， to establish an acute alcoholic liver injury model. On the 16th day of the experiment， the liver indexes of mice in each group were calculated； the serum levels of alanine transaminase （ALT）， aspartate transaminase （AST）， total cholesterol （TC）， triglycerides （TG）， malondialdehyde （MDA） and glutathione （GSH） were also determined. The histopathological morphology of their liver tissues was observed and scored. The protein expressions of cytochrome P450 2E1 （CYP2E1）， Kelch-like ECH-associated protein 1 （Keap1）， nuclear factor erythroid 2-related factor 2 （Nrf2） and NAD（P）H： quinone oxidoreductase 1 （NQO1） were measured in liver tissue. RESULTS Compared with model group， mice in each dosage group of alisol B 23-acetate showed varying degrees of recovery in body weight， along with improvements in pathological changes in liver tissues such as inflammatory cell infiltration and fatty vacu oles. Their liver indexes， histopathological scores of liver tissue， serum levels of ALT， AST， TC， TG and MDA， as well as the protein expressions of CYP2E1 and Keap1 in liver tissue， were all significantly decreased （ P ＜0.05 or P ＜0.01）. The serum GSH levels and the protein expressions of Nrf2 （except for the alisol B 23-acetate low-dose group） and NQO1 in liver tissue were significantly increased （ P ＜0.05 or P ＜0.01）， and the changes in the above quantitative indicators showed a dose-dependent pattern. CONCLUSIONS Alisol B 23-acetate can ameliorate acute alcoholic liver injury in mice， and its mechanism may be related to improving antioxidant capacity by regulating the Keap1/Nrf2/NQO1 signaling pathway while simultaneously improving liver lipid metabolism-related indexes.

ObjectiveTo evaluate the predictive value of epicardial adipose tissue （EAT） parameters for microvascular obstruction （MVO） formation in patients with ST segment elevation myocardial infarction （STEMI） using cardiac magnetic resonance quantification. MethodsA total of 139 STEMI patients were included in this study， and various parameters such as EAT thickness， volume， and mass index were measured utilizing cardiac magnetic resonance. All included patients were divided into MVO group and non-MVO group according to whether MVO occurred. Differences in EAT related parameters between two groups were compared and correlation analysis was applied to evaluate the correlation between quantitative indicators of EAT and indicators such as infarct size and ejection fraction. Logistic regression analysis was used to identify the relevant risk factors for MVO formation. Receiver Operating Characteristic （ROC） curve analysis was performed to assess the predictive value of the epicardial adipose tissue （EAT） quality index and other indicators for the occurrence of MVO. ResultsCompared with non MVO group， patients in MVO group presented with higher peak troponin T levels， increase of neutrophil lymphocyte ratio （NLR） and C-reactive protein （CRP）， larger infarct size and compromised left ventricular ejection fraction （LVEF） （P<0.05）. Total EAT volume， EAT mass index， left atrioventricular EAT volume， left atrioventricular EAT mass index and thickness of EAT in the left atrioventricular groove were significantly higher in patients with MVO. Multivariate Logistic regression analysis demonstrated that NLR， peak troponin T levels and left atrioventricular EAT mass index were independent predictors of MVO. The ROC curve suggested that the left atrioventricular EAT mass index had the highest predictive power for MVO formation in STEMI patients. ConclusionThe parameters of EAT quantified by cardiac magnetic resonance serve as imaging biomarkers for predicting MVO formation in STEMI patients. These metrics enable risk stratification post-myocardial infarction and facilitate early identification of high-risk individuals， thereby supporting personalized therapeutic decision-making.

BACKGROUND:Lijin manipulation can promote skeletal muscle repair and treat skeletal muscle injury.However,the formation of fibrosis and scar tissue hyperplasia are closely related to the quality of skeletal muscle repair.To study the regulatory effect of Lijin manipulation on the formation of fibrosis and scar tissue hyperplasia is helpful to explain the related mechanism of Lijin manipulation to improve the repair quality of skeletal muscle injury. OBJECTIVE:To explore the mechanism of Lijin manipulation to improve the repair quality of skeletal muscle injury in rabbits,thereby providing a scientific basis for clinical treatment. METHODS:Forty-five healthy adult Japanese large-ear white rabbits were randomly divided into blank group,model group and Lijin group,with 15 rats in each group.Gastrocnemius strike modeling was performed in both model group and Lijin group.The Lijin group began to intervene with tendon manipulation on the 3rd day after modeling,once a day,and 15 minutes at a time.Five animals in each group were killed on the 7th,14th and 21st days after modeling.The morphology and inflammatory cell count of gastrocnemius were observed by hematoxylin-eosin staining,the collagen fiber amount was observed by Masson staining,the expression of interleukin-6 and interleukin-10 in gastrocnemius was detected by ELISA.The protein and mRNA expressions of paired cassette gene 7,myogenic differentiation factor,myoblastogenin,alpha-actin,transforming growth factor beta 1,and type Ⅰ collagen were detected by western blot and RT-PCR,respectively,and the expression of type Ⅰ collagen protein was detected by immunohistochemistry. RESULTS AND CONCLUSION:Hematoxylin-eosin staining and Masson staining showed that compared with the model group,inflammatory cell infiltration and collagen fiber content decreased in the Lijin group(P<0.01),and the muscle fibers gradually healed.ELISA results showed that compared with the model group,the expression of interleukin-6 in the Lijin group continued to decrease(P<0.05),and the expression of interleukin-10 increased on the 7th day after modeling(P<0.05)and then showed a decreasing trend(P<0.05).Western blot and RT-PCR results showed that compared with the model group,the protein and mRNA expressions of paired cassette gene 7,myogenic differentiation factor,myoblastogenin in the Lijin group were significantly increased on the 14th day after modeling(P<0.05),but decreased on the 21st day(P<0.05);the protein and mRNA expressions of alpha-actin,transforming growth factor beta 1,and type Ⅰ collagen in the Lijin group were significantly decreased compared with those in the model group(P<0.05).Immunohistochemical results showed that the expression of type Ⅰ collagen in the Lijin group was significantly lower than that in the model group(P<0.05).To conclude,Lijin manipulation could improve the repair quality of skeletal muscle injury by inhibiting inflammation,promoting the proliferation and differentiation of muscle satellite cells,and reducing fibrosis.

The integration of science and education is not only an important strategy for promoting social progress and technological development,but also a modern form of higher education aiming at cultivating innovative talents.Conducting scientific research training for undergraduate medical students is one of the important ways to cultivate their innovative abilities and comprehensive qualities.Our team proposed a"teaching,science,and ideology trinity"teaching model to comprehensively cultivate students' scientific research comprehensive abilities under the value orientation of ideological and political education by or-ganically integrating molecular biology experimental teaching with the scientific research training of under-graduate medical students.In this teaching activity,taking the experiment of gene polymorphism as an example,our team selected students with research potential from the whole grade and divided them into 4 project groups that were instructed by 4 teachers.The students were trained in the whole process of scien-tific research,including topic selection,project writing,experimental designing,application for research ethics,and project summary.Our team has always adhered to student-contentedness of educational con-cepts to stimulate students' intrinsic motivation throughout the teaching process.Students are the design-ers and implementers of the project,and teachers are only guides and promoters of learning.After this training,students not only became familiar with the writing and implementation of scientific research pro-jects,but also improved their literature reading,experimental designing,experimental skills,and prob-lem-solving abilities.More importantly,this teaching activity also cultivated students' awareness of re-search ethics and academic moral standards.

To formulate an expert consensus on the principles of preoperative hair removal and provide scientific guidance for standardized removal of hair before surgical procedures so as to reduce the incidence of surgical site infections.METHODS Led by the Hospital Management Institute of National Health Commission of the People's Republic of China,this consensus was reached with the joint efforts from the expects of relevant fields such as surgeries,interventional therapies,nursing,and infection prevention and control.The consensus facilitates the classification and evaluation of literatures by following the evidence grade formulated by Oxford Evidence-based Medicine Center and focuses on the association of preoperative hair removal with surgical site infection,it reaches the evidence grade of expert consensus and recommendation intensity by integrating with discussions on meetings and clinical experience of the expects from relevant fields.RESULTS A total of 6 items of consensus were reached by summarizing the latest evidence on the aspects including the indications for preoperative hair removal,tools,range,timing and places.CONCLUSION The consensus,to some extent,make supplements to and complete the exiting regulations and standards.It provides guidance for the medical institutions to carry out the preoperative hair removal.

Objective To compare imaging quality and semi-quantitative parameters of 18F-FDG whole-body images obtained with domestic NeuWise and Philips Ingenuity TF PET/CT scanners.Methods Thirty-four patients who underwent 18F-FDG whole-body scanning using NeuWise and Philips Ingenuity TF PET/CT systems respectively on the same day were enrolled.The imaging quality and semi-quantitative parameters of 2 kind images,also the mean standard uptake value(SUVmean)of normal tissue,the maximum standard uptake value(SUVmax),peak standard uptake value(SUVpeak),SUVmean of lesions,total lesion glycolysis(TLG)and metabolic tumor volume(MTV)were compared.Results No significant difference of imaging quality nor semi-quantitative parameters of lesions(all P＞0.05),while significant differences of SUVmean of aortic arch,liver,lumbar vertebra and spinal cord were found between 2 kind images(all P＜0.05).Strong correlations of SUVmax,SUVmean,MTV and TLG of lesions(r,=0.734-0.890,P＜0.001),and high correlation of SUVpeak(rs=0.919,P＜0.001)were found between 2 kind images.The consistency of SUVmax,SUVpeak,SUVmean,TLG and MTV at the lesion site between 2 kind images were very good to extremely good(ICC=0.891-0.986,all P＜0.001),and the differences of all above semi-quantitative parameters were within 95％confidence interval.Conclusion Imaging quality of 18F-FDG whole-body images obtained with domestic NeuWise and Philips Ingenuity TF PET/CT scanners could meet the requirements of clinical diagnosis and treatment,and semi-quantitative parameters obtained based on both images had good consistencies.

OBJECTIVE To evaluate the differences between the sampling methods of peristaltic pump+membrane filtration and rinsing for monitoring the cleaning and disinfection effectiveness of flexible endoscopes,and to pro-vide a reference for selecting an efficient sampling method for monitoring the cleaning and disinfection effectiveness of flexible endoscopes.METHODS A total of 305 cases of monitoring data on the cleaning and disinfection of flexi-ble endoscopes from People's Hospital of Rizhao in Shandong Province from Jan.2021 to Dec.2024 were selected.The results of 93 cases sampled by rinsing from Jan.2021 to Dec.2022 were compared with those of 212 cases sampled by peristaltic pump+membrane filtration from Jan.2023 to Dec.2024.The monitoring capabilities of different sampling methods for flexible endoscopes after cleaning and disinfection were evaluated,and the con-sumable costs of different sampling methods were also calculated.RESULTS The detection rate of pathogenic bac-teria after biological monitoring of the peristaltic pump+membrane filtration sampling method was 25.94％(55/212),which was higher than that of the rinsing sampling method(8.60％,8/93)(P＜0.05).There was no sta-tistically significant difference in the sampling qualification rate between the two methods(P=0.075).There was no statistically significant difference in the qualification rate between manual and mechanical cleaning and dis-infection methods under the same sampling method.However,there was a statistically significant difference in the detection rate of pathogenic bacteria between manual cleaning and disinfection(36.21％)and mechanical cleaning and disinfection(22.08％)under the peristaltic pump+membrane filtration sampling method(P=0.036).The detection rate of pathogenic bacteria of the peristaltic pump+membrane filtration sampling method was higher than that of the rinsing sampling method for both cleaning and disinfection methods(P＜0.05).The consumable cost per endoscope of the peristaltic pump+membrane filtration sampling method was(84.90±2.91)yuan,which was higher than that of the rinsing sampling method(32.24±4.73)yuan(P＜0.001).CONCLUSION Al-though the peristaltic pump+membrane filtration sampling method has higher consumable costs,it can effec-tively improve the detection rate of pathogenic bacteria and enhance the sensitivity of biological monitoring of cleaning and disinfection.

Aim To investigate the effects of SAHA on the expression of P-gp and the pharmacokinetic pa-rameters of its substrate phenytoin sodium in rats under hypoxic environments.Methods Wistar rats were randomly divided into the normioxic group,the hypoxic model group,and the low-,medium-and high-dose vorinostat(SAHA)groups.Liver tissues were col-lected,and the expression levels of P-gp and HDAC5 were detected by Real-time PCR and Western blot.The morphological changes of liver tissues were ob-served by HE staining.Following intragastric adminis-tration of 50 mg·kg-1 phenytoin sodium to each group,blood samples were collected,and the plasma concentration of phenytoin sodium was determined u-sing UFLC-MS/MS to calculate pharmacokinetic pa-rameters.Results Compared with the normoxic group,the expression of HDAC5 in the liver tissues of hypoxia model rats increased,while the expression of P-gp decreased.After SAHA treatment,HDAC5 expression decreased,and P-gp expression increased.Among the SAHA groups,the medium-dose group showed the most significant effect,and HE staining re-sults indicated that this concentration did not cause damage to rat liver tissues.Compared with the normox-ic group,the AUC,Cmax,and T1/2 of phenytoin sodium in hypoxia model rats were significantly raised.After administration of the medium dose of SAHA,the AUC,Cmax,MRT,and T1/2 were significantly reduced,while CLZ/r was significantly increased.Conclusions Un-der hypoxic environments,the expression of P-gp in rat liver tissue is significantly downregulated,leading to increased systemic exposure of phenytoin,reduced clearance,and consequently elevated blood concentra-tions,raising the risk of central nervous system toxici-ty.In contrast,SAHA suppresses HDAC5 expression,thereby activating P-gp transcription and enhancing its efflux function.This results in decreased systemic ex-posure and improved clearance of phenytoin,signifi-cantly reducing drug accumulation in body and ulti-mately lowering the risk of adverse effects.

BACKGROUND:Electroacupuncture can treat oligoasthenospermia by stimulating hormone synthesis and release in the hypothalamus,pituitary gland and testis,but its mechanism is complex,and the efficacy of electroacupuncture is closely related to the idea of acupoint compatibility.OBJECTIVE:To explore whether electroacupuncture therapy can improve the function status of hypothalamic-pituitary-testicular axis by adjusting the level of serum related sex hormones in rats,so as to treat adenine-induced oligoasthenospermia in rats.METHODS:Fifty adult male Sprague-Dawley rats were randomly divided into blank,model,electroacupuncture,L-carnitine,and non-meridian and non-acupuncture point groups,with 10 rats in each group.Except for the blank group,the rats in the other four groups were given 200 mg/(kg·d)adenine via intragastric administration for 28 days to establish oligoasthenospermia models.After modeling,the rats in the electroacupuncture group were given electroacupuncture treatment at Zhongji,Guanyuan,Zusanli and Sanyinjiao acupoints,the non-acupoint group was selected for electroacupuncture treatment at three non-acupoint points,and the rats in the L-carnitine group were given oral infusion of L-carnitine,once daily,for 28 continuous days.After treatment,the kidney and testicular organ coefficients were calculated.Sperm count,survival rate and motility rate were determined.Pathological morphological changes of kidney and testicular tissues were observed.Serum sex hormones testosterone,gonadotropin releasing hormone,follicle stimulating hormone,luteinizing hormone,estradiol,statin B and prolactin levels were detected in rats of each group.RESULTS AND CONCLUSION:(1)The renal organ coefficient in the model group was higher than that in the blank,electroacupuncture and L-carnitine groups(P＜0.05),the renal organ coefficient in the non-acupoint group was higher than that in the electroacupuncture group(P＜0.05),and there was no significant difference in the testicular organ coefficient among all groups(P＞0.05).(2)Compared with the blank group,sperm count,survival rate and motility rate were decreased in the model group(P＜0.05);compared with the model group,sperm count,survival rate and motility rate were increased in the electroacupuncture group and L-carnitine group(P＜0.05);compared with the non-acupoint group,sperm count,survival rate and motility rate were higher in the electroacupuncture group(P＜0.05).(3)Hematoxylin-eosin staining results indicated that the kidney and testicular tissues of rats in the model group were severely damaged,while damage to kidney and testicular tissues was less in the electroacupuncture group and L-carnitine group compared with the model group,but severer in the non-acupoint group than the electroacupuncture group.(4)Compared with the blank group,the levels of testosterone,gonadotropin releasing hormone,and inhibin B in the serum of rats in the model group were decreased(P＜0.05),and the levels of follicle-stimulating hormone,luteinizing hormone,estradiol,and prolactin were increased(P＜0.05).Compared with the model group,the levels of testosterone,gonadotropin-releasing hormone,and inhibin B in the serum of rats in the electroacupuncture group and L-carnitine group were increased(P＜0.05),and the levels of follicle-stimulating hormone,luteinizing hormone,estradiol,and prolactin were decreased(P＜0.05).Compared with the non-acupoint group,the levels of testosterone,gonadotropin-releasing hormone,and inhibin Bin the serum of the rats in electroacupuncture group were increased(P＜0.05),and the levels of follicle-stimulating hormone,luteinizing hormone,estradiol,and prolactin were decreased(P＜0.05).To conclude,electroacupuncture at Zhongji,Guanyuan,Zusanli,and Sanyinjiao acupoints can effectively treat oligoasthenospermia by regulating the functional state of the hypothalamic-pituitary-testicular axis in rats.

With the continuous evolution of minimally invasive surgical concepts,operative techniques are progressively advancing from"minimal injury"toward"scarless"approaches.Super-minimally laparoscopic surgery(SMLS)is a novel surgical modality developed on the basis of conventional laparoscopic techniques through the innovation and recombination of operative elements,aiming to achieve smaller trauma and improved cosmetic outcomes.Utilizing the umbilical skin fold as a natural scar-concealing site,SMLS establishes no more than two primary operating channels(maximum diameter≤15 mm),supplemented by auxiliary ports≤2 mm in diameter on the abdominal wall.Combined with innovative separable surgical instruments and high-definition visualization systems,this approach provides a systematic solution to key issues such as residual access-site scarring.This review summarizes the development,technical innovations,current clinical applications,and potential aesthetic value of SMLS in the evolution of minimally invasive surgery,aiming to offer theoretical insights and research reference for its future promotion and technical refinement.