Cholesterol is a crucial lipid in the human body.Elevated levels of cholesterol can result in condi-tions such as hypercholesterolemia.3-hydroxy-3-methylglutaryl coenzyme A reductase(HMGCR)serves as a pivotal en-zyme in the synthesis of cholesterol,acting as a rate-limiting factor.As a result,HMGCR plays a critical role in maintain-ing cholesterol balance,with the regulatory processes being intricate in vivo.This review outlines the advancements in un-derstanding the regulatory mechanisms of HMGCR,encompassing transcriptional control,degradation pathways,and en-zyme activity.

Cholesterol is a crucial lipid in the human body.Elevated levels of cholesterol can result in condi-tions such as hypercholesterolemia.3-hydroxy-3-methylglutaryl coenzyme A reductase(HMGCR)serves as a pivotal en-zyme in the synthesis of cholesterol,acting as a rate-limiting factor.As a result,HMGCR plays a critical role in maintain-ing cholesterol balance,with the regulatory processes being intricate in vivo.This review outlines the advancements in un-derstanding the regulatory mechanisms of HMGCR,encompassing transcriptional control,degradation pathways,and en-zyme activity.

Decidualization is the differentiation of endometrial stromal cells into secretory decidual stromal cells. Human decidualization involves some amount of signaling molecules and pathways as well as genetic reprogramming, which is driven by the postovulatory rise in progesterone levels and local cyclic adenosine monophosphate production. Decidualization extends from the primary decidual zone to the secondary decidual zone, and then exits through apoptosis. Evidences support that decidual fibroblasts function as the pool of decidual stromal cells during pregnancy. Decidualization undergoes an acute inflammatory phase, an anti-inflammatory secretory phase to the final recession phase. The decidualization of the inner layer of endometrium, termed decidua, is the most critical determinant of pregnancy success, which can promote placenta formation, modulate immune tolerance, foster resistance to oxidative stress, sense embryo quality, and control labor. Failure to adequate decidualization in terms of hormones, biochemistry, and immunology leads to adverse pregnancy outcomes, including diseases such as preeclampsia, miscarriage, premature labor, repeated implantation failures, and some age-related decline in reproductive capacity. The development of animal models and in vitro culture systems combined with emerging technologies provides a powerful system to explore the mechanism of decidualization. However, decidualization is a dynamic, multi-step process, and translating of current research progress into disease predictions and interventions for pregnancy complications remains to be achieved. The study of periodic regeneration and spontaneous decidualization of the endometrium will be beneficial to the diagnosis and treatment of pregnancy diseases.

Decidualization is the differentiation of endometrial stromal cells into secretory decidual stromal cells. Human decidualization involves some amount of signaling molecules and pathways as well as genetic reprogramming, which is driven by the postovulatory rise in progesterone levels and local cyclic adenosine monophosphate production. Decidualization extends from the primary decidual zone to the secondary decidual zone, and then exits through apoptosis. Evidences support that decidual fibroblasts function as the pool of decidual stromal cells during pregnancy. Decidualization undergoes an acute inflammatory phase, an anti-inflammatory secretory phase to the final recession phase. The decidualization of the inner layer of endometrium, termed decidua, is the most critical determinant of pregnancy success, which can promote placenta formation, modulate immune tolerance, foster resistance to oxidative stress, sense embryo quality, and control labor. Failure to adequate decidualization in terms of hormones, biochemistry, and immunology leads to adverse pregnancy outcomes, including diseases such as preeclampsia, miscarriage, premature labor, repeated implantation failures, and some age-related decline in reproductive capacity. The development of animal models and in vitro culture systems combined with emerging technologies provides a powerful system to explore the mechanism of decidualization. However, decidualization is a dynamic, multi-step process, and translating of current research progress into disease predictions and interventions for pregnancy complications remains to be achieved. The study of periodic regeneration and spontaneous decidualization of the endometrium will be beneficial to the diagnosis and treatment of pregnancy diseases.

Objective:To investigate the correlation between vitamin D deficiency and the severity of symptoms in children with vasovagal syncope (VVS).Methods:A prospective study was conducted. One hundred and twenty-two children diagnosed with VVS by head up tilt test in Department of Pediatric Cardiology and 130 healthy children without symptoms who underwent physical examination in the outpatient department of Child Healthcare Department of Second Hospital of Lanzhou University from December 2019 to May 2021 were selected and assigned to VVS group and control group, respectively. According to the diagnostic criteria of vitamin D deficiency, children in the VVS group were assigned to three subgroups: non-vitamin D deficiency, vitamin D deficiency, and severe vitamin D deficiency. All children underwent detailed history taking, physical examination, and level determination of serum 25 (OH) D. Children in the VVS group were scored for orthostatic intolerance (OI) symptoms including 10 symptoms: syncope, dizziness, nausea, palpitation, headache, tremor, chest tightness, blurred vision, profuse perspiration, and attention deficit. The differences in the age, gender, body mass index, blood pressure, and serum 25 (OH) D levels between VVS group and control group, and the differences regarding the age, gender, body mass index, blood pressure, serum 25 (OH) D levels and symptom scores among the three VVS subgroups were compared. Comparisons were performed using independent sample t test, ANOVA analysis, Chi square test and rank sum test. Pearson correlation analysis was used to analyze the correlation between serum 25 (OH) D levels and OI symptom scores in children with VVS. Results:The serum 25 (OH) D levels were significantly lower in the VVS group than those in the control group ((31±11) vs. (46±10) nmol/L, t=10.89, P<0.001). Vitamin D deficiency was more frequent in the VVS group (73.0% (89/122) vs. 24.6% (32/130), χ2=58.91, P<0.001). There were significant differences among the severe vitamin D deficiency subgroup, vitamin D deficiency subgroup, and non-vitamin D deficiency subgroup regarding the serum 25 (OH) D levels ((9.8±0.4) vs. (26.6±6.5) vs. (45.8±5.9) nmol/L, F=142.77, P<0.001) and the OI symptom scores ((14±1) vs. (10±2) vs. (7±2) scores, F=44.97, P<0.001). The scores of syncope, nausea, profuse perspiration, blurred vision and dizziness among the severe vitamin D deficiency subgroup, vitamin D deficiency subgroup, and non-vitamin D deficiency subgroup were statistically significant ( H=9.01, 7.52, 12.11, 7.07 and 9.54, respectively, all P<0.05). Pearson correlation analysis showed that the serum 25 (OH) D levels were negatively correlated with OI symptom scores in children with VVS ( r=-0.769, P<0.001). Conclusions:VVS children have significant vitamin D deficiency. The severity of symptoms increases with decreasing of vitamin D level. Syncope, nausea, and profuse perspiration are more likely to occur in children with severe vitamin D deficiency, and dizziness and blurred vision are more likely to occur in children with vitamin D deficiency.

Objective To summarize the clinical experience of laparoscopic total extraperitoneal hernia repair (TEP) combined with varicocele ligation for treating inguinal hernia combining with varicocele (VC).Methods Clinical data of 22 patients of inguinal hernia complicated with varicocele from April 2011 to April 2016 was retrospectively analyzed. All the patients were treated by TEP combined with high ligation of spermatic vein. Then monitor and analyzed clinical indexes intra- and postoperatively.Results The mean operation time was (55.0 ± 9.0) min, mean intraoperative blood loss was (5.5 ± 2.8) ml, all patients can eat after anesthesia recovery and off-bed after staying in bed for 24 hours; all patients don’t need postoperative analgesia; only 1 case suffered seroma postoperative; the average hospitalization time was (4.7 ± 0.9) days; postoperative follow-up of 1 to 5 year without recurrence.Conclusion The surgical effect of TEP combined with varicocele ligation is confirmed with less invasive, faster postoperative recovery and achieving an obvious social and economical effect, it is worthy of deserving further clinical application.

Hematogenous metastasis is common in lung cancer, and except for small cell lung cancer and melanoma, tumors with extensive metastasis seldom involve the prostate. The treatment of lung adenocarcinoma with prostate metastasis relies mainly on systemic chemotherapy with rigorous treatment of the primary lesions and metastatic palliative radiotherapy. Comprehensive treatment integrating traditional Chinese medicine may improve the quality of life of the patients.
Adenocarcinoma ; pathology ; Aged ; Humans ; Lung Neoplasms ; pathology ; Male ; Neoplasm Metastasis ; Prostatic Neoplasms ; secondary

Chinese medical records recorded the whole activities during a syndrome differentiation and treatment of disease. With the characteristics of diversity and lively, the records have important values in establishing TCM therapeutic thoughts and abilities for students. Amount of medical records have been recorded in medical books since the Western Han dynasty. In order to provide the references for teaching prescription aided by medical records, this article discusses the choice and application of medical records to teach prescription by listing examples on the basis of outlining the development of TCM medical records.

Hematogenous metastasis is common in lung cancer, and except for small cell lung cancer and melanoma, tumors with extensive metastasis seldom involve the prostate. The treatment of lung adenocarcinoma with prostate metastasis relies mainly on systemic chemotherapy with rigorous treatment of the primary lesions and metastatic palliative radiotherapy. Comprehensive treatment integrating traditional Chinese medicine may improve the quality of life of the patients.

Hematogenous metastasis is common in lung cancer, and except for small cell lung cancer and melanoma, tumors with extensive metastasis seldom involve the prostate. The treatment of lung adenocarcinoma with prostate metastasis relies mainly on systemic chemotherapy with rigorous treatment of the primary lesions and metastatic palliative radiotherapy. Comprehensive treatment integrating traditional Chinese medicine may improve the quality of life of the patients.