The European Society of Cardiology (ESC) released the "2024 ESC guidelines for the management of elevated blood pressure and hypertension" on August 30, 2024. This guideline updates the 2018 "Guidelines for the management of arterial hypertension." One notable update is the introduction of the concept of "elevated blood pressure" (120-139/70-89 mm Hg). Additionally, a new systolic blood pressure target range of 120-129 mm Hg has been proposed for most patients receiving antihypertensive treatment. The guideline also includes numerous additions or revisions in areas such as non-pharmacological interventions and device-based treatments for hypertension. This article interprets the guideline's recommendations on definition and classification of elevated blood pressure and hypertension, and cardiovascular disease risk assessment, diagnosing hypertension and investigating underlying causes, preventing and treating elevated blood pressure and hypertension. We provide a comparison interpretation with the 2018 "Guidelines for the management of arterial hypertension" and the "2017 ACC/AHA guideline on the prevention, detection, evaluation, and management of high blood pressure in adults."

Objective:To analyze the prevalence, trends in disease burden, and risk factors of esophageal cancer in various provinces of China from 1990 to 2019.Methods:Utilizing data from the 2019 global burden of disease study, the disease burden of esophageal cancer of 31 provinces, municipalities, and autonomous regions, as well as Hong Kong Special Administrative Region and Macao Special Administrative Region of China from 1990 to 2019 were analyzed. The disease burden of esophageal cancer in China was described with the number (and incidence) of cases, the number (and mortality) of death, and disability-adjusted life year (DALY) and their age-standardized rates. Joinpoint regression analysis and t-test were used to evaluate the annual percent change and the average annual percent change (AAPC). Scatter plots and Spearman correlation coefficients were performed to analyze the correlation between the disease burden of esophageal cancer and the socio-demographic index (SDI), as well as DALY in each province. Results:In 2019, there were 278 121 new cases of esophageal cancer and 257 316 deaths in China, increased by 60.13% and 45.70% respectively compared with 1990. The top 3 provinces with the highest age-standardized incidence of esophageal cancer were Sichuan Province (25.96/100 000), Jiangsu Province (23.80/100 000), and Fujian Province (21.98/100 000). From 1990 to 2019, except for Jiangsu Province and Sichuan Province, the age-standardized incidence in other provinces showed a declining trend. The age-standardized mortality and DALYs of esophageal cancer decreased in all provinces as well as in Hong Kong and Macao Special Administrative Regions of China. The attributable risk factors of esophageal cancer caused deaths in China mainly included smoking, alcohol consumption, high body mass index, and low fruit intake, accounting for 91.38% of all the cases. With the increase of the SDI, the age-standardized rates of DALY in high incidence areas of esophageal cancer (Sichuan Province, Jiangsu Province, Fujian Province, Henan Province, Chongqing City, Xinjiang Uygur Autonomous Region, Shanxi Province, and Anhui Province) demonstrated a trend of initially decline and then an upward. In contrast, the age-standardized rates of DALY of esophageal cancer in other provinces, as well as in Hong Kong and Macao Special Administrative Regions of China, showed a trend of initially upward and then decline. The age-standardized rate of DALY of esophageal cancer showed a negative correlation with SDI ( r=-0.315, P<0.001). From 1990 to 2019, the age-standardized incidence and mortality of esophageal cancer generally demonstrated a downward trend. The AAPC was -1.43% ( t=-19.16, P<0.001) for incidence and -1.83% ( t=-29.63, P<0.001) for mortality, respectively. It is projected that by 2044, the actual number of new esophageal cancer cases in China will increase from 278 121 in 2019 to 291 206 in 2044, and the actual number of deaths will increase from 257 316 to 275 856. Conclusions:In recent years, the disease burden of esophageal cancer in China remains a serious status, with significant differences in geography and gender. It is projected that by 2044, the number of new esophageal cancer cases and deaths in China will continue to increase. Effective strategies and policies are urgently needed to reduce the disease burden.

With the rapid development of generative artificial intelligence(GAI)technologies,their widespread application in academic research and writing is continuously expanding the boundaries of sci-entific inquiry.However,this trend has also raised a series of ethical and regulatory challenges,inclu-ding issues related to authorship,content authenticity,citation accuracy,and accountability.In light of the growing involvement of AI in generating academic content,establishing an open,controllable,and trustworthy ethical governance framework has become a key task for safeguarding research integrity and maintaining trust within the academic community.This expert consensus outlines ethical requirements across key stages of AI-assisted academic writing-including topic selection,data management,citation practices,and authorship attribution.It aims to clarify the boundaries and ethical obligations surrounding AI use in academic writing,ensuring that technological tools enhance efficiency without compromising in-tegrity.The goal is to provide guidance and institutional support for building a responsible and sustainable research ecosystem.

Objective:To analyze the prevalence, trends in disease burden, and risk factors of esophageal cancer in various provinces of China from 1990 to 2019.Methods:Utilizing data from the 2019 global burden of disease study, the disease burden of esophageal cancer of 31 provinces, municipalities, and autonomous regions, as well as Hong Kong Special Administrative Region and Macao Special Administrative Region of China from 1990 to 2019 were analyzed. The disease burden of esophageal cancer in China was described with the number (and incidence) of cases, the number (and mortality) of death, and disability-adjusted life year (DALY) and their age-standardized rates. Joinpoint regression analysis and t-test were used to evaluate the annual percent change and the average annual percent change (AAPC). Scatter plots and Spearman correlation coefficients were performed to analyze the correlation between the disease burden of esophageal cancer and the socio-demographic index (SDI), as well as DALY in each province. Results:In 2019, there were 278 121 new cases of esophageal cancer and 257 316 deaths in China, increased by 60.13% and 45.70% respectively compared with 1990. The top 3 provinces with the highest age-standardized incidence of esophageal cancer were Sichuan Province (25.96/100 000), Jiangsu Province (23.80/100 000), and Fujian Province (21.98/100 000). From 1990 to 2019, except for Jiangsu Province and Sichuan Province, the age-standardized incidence in other provinces showed a declining trend. The age-standardized mortality and DALYs of esophageal cancer decreased in all provinces as well as in Hong Kong and Macao Special Administrative Regions of China. The attributable risk factors of esophageal cancer caused deaths in China mainly included smoking, alcohol consumption, high body mass index, and low fruit intake, accounting for 91.38% of all the cases. With the increase of the SDI, the age-standardized rates of DALY in high incidence areas of esophageal cancer (Sichuan Province, Jiangsu Province, Fujian Province, Henan Province, Chongqing City, Xinjiang Uygur Autonomous Region, Shanxi Province, and Anhui Province) demonstrated a trend of initially decline and then an upward. In contrast, the age-standardized rates of DALY of esophageal cancer in other provinces, as well as in Hong Kong and Macao Special Administrative Regions of China, showed a trend of initially upward and then decline. The age-standardized rate of DALY of esophageal cancer showed a negative correlation with SDI ( r=-0.315, P<0.001). From 1990 to 2019, the age-standardized incidence and mortality of esophageal cancer generally demonstrated a downward trend. The AAPC was -1.43% ( t=-19.16, P<0.001) for incidence and -1.83% ( t=-29.63, P<0.001) for mortality, respectively. It is projected that by 2044, the actual number of new esophageal cancer cases in China will increase from 278 121 in 2019 to 291 206 in 2044, and the actual number of deaths will increase from 257 316 to 275 856. Conclusions:In recent years, the disease burden of esophageal cancer in China remains a serious status, with significant differences in geography and gender. It is projected that by 2044, the number of new esophageal cancer cases and deaths in China will continue to increase. Effective strategies and policies are urgently needed to reduce the disease burden.

Objective:To evaluate the efficacy and safety of the CLAE (cladribine + cytarabine + etoposide) regimen in refractory/relapsed T cell acute lymphoblastic leukemia/lymphoma (R/R T-ALL/LBL) .Methods:Patients with R/R T-ALL/LBL received the CLAE regimen in a prospective, multicenter, single-arm clinical study or compassionate use. From March 2019 to August 2024, data from 25 patients (18 in the study across five centers and 7 receiving compassionate treatment in Peking University Third Hospital) were collected. Outcomes included objective response rate, complete response (CR) rate, partial response (PR) rate after 1–2 cycles, bridging to allo-HSCT, progression-free survival (PFS), overall survival (OS), and treatment-related adverse effects.Results:Median age was 29 years (range, 13–63) ; 17 were male. Among the 24 evaluable patients, CR rate was 33.3% overall and 41.2% among enrolled patients. Median OS and PFS time were 199 (46–1 310) and 49 (28–1 310) days, respectively. Cumulative OS rate at 6 months, 1 year, and 2 years was (52.1±10.2) %, (29.7±9.3) %, and (27.1±9.1) %, respectively; cumulative PFS rate was (32.6±9.6) %, (24.9±8.9) %, and (23.8±8.7) %, respectively. Among patients achieving CR or PR (8 cases), median OS and PFS were not reached. Cumulative OS rate at 6 months, 1 year, and 2 years was (86.8±12.0) %, (78.3±14.6) %, and (72.9±15.7) %, respectively, and the cumulative PFS rate was (86.4±12.1) %, (74.8±15.3) %, and (72.9±15.7) %, respectively. Adverse events were mainly hematologic; no treatment-related mortality occurred. Seven patients achieving CR were bridged to allo-HSCT, with 5 remaining in continuous remission.Conclusion:The CLAE regimen is safe and effective for R/R T-ALL/LBL, facilitating CR as a bridge to allo-HSCT and potentially improving patient prognosis.

Objective:To construct a device-related pressure injury prevention program for orthopedic patients based on evidence-based and SSKINS (S: skin, S: surface, K: keep moving, I: incontinence, N: nutrition, S: self-care) clinical management model, and to provide reference for clinical nursing practice.Methods:In June 2023, a research team was set up to retrieve the literature related to device-related pressure injury in orthopedic patients, and the evidence was extracted and screened with reference to the SSKINS clinical management model, and the first draft of the protocol was formulated based on clinical practice. The final plan was determined through two rounds of expert consultations from October to December 2023.Results:The response rate of the two rounds of expert correspondence was 100%(20/20). The expert authority coefficients were 0.897 and 0.907, the overall Kendall coordination coefficients of the two rounds were 0.116 and 0.136 respectively, and the Kendall coordination coefficients of all levels were 0.104-0.213 (all P<0.001). The final protocol contains 6 first-level items (assessment and examination, the use and adjustment of device, prophylactic dressings, skin protection, nutritional support, health education) and 31 second-level items. Conclusions:The proposed orthopedic device-related pressure injury prevention program is scientific and practical, and can provide a reference for the prevention and management of clinical medical staff.

With the establishment of bio-psycho-social medical model,both social and psychological factors play an important role in the occurrence,development and treatment of diseases.Hypertension is a common chronic multiple disease in China,and patients are often complicated with depression and other e-motional disorders.The interaction between hypertension and depression significantly increases the risk of poor prognosis.Current studies have shown a bidirectional promoting relationship between hypertension and depression,and they have some com-mon pathogenesis.However,the specific mechanism of their co-morbidity has not been fully elucidated.Renin-angiotensin sys-tem(RAS)plays an important role in the regulation of hyperten-sion and depression and other emotions.It is composed of two antagonistic pathways.The balance is maintained by angioten-sin-converting enzyme 2(ACE2).Therefore,this article reviews the relationship and mechanism of RAS in hypertension,depres-sion and comorbid states,in order to provide new treatment ide-as for hypertension and depression.

Intraoperative cell salvage (IOCS) has been widely applied as an important blood conservation measure in surgical operations. However, there is currently a lack of clinical practice guidelines for the implementation of IOCS in patients with malignant tumors. This report aims to provide clinicians with recommendations on the use of IOCS in patients with malignant tumors based on the review and assessment of the existed evidence. Data were derived from databases such as PubMed, Embase, the Cochrane Library and Wanfang. The guideline development team formulated recommendations based on the quality of evidence, balance of benefits and harms, patient preferences, and health economic assessments. This study constructed seven major clinical questions. The main conclusions of this guideline are as follows: 1) Compared with no perioperative allogeneic blood transfusion (NPABT), perioperative allogeneic blood transfusion (PABT) leads to a more unfavorable prognosis in cancer patients (Recommended); 2) Compared with the transfusion of allogeneic blood or no transfusion, IOCS does not lead to a more unfavorable prognosis in cancer patients (Recommended); 3) The implementation of IOCS in cancer patients is economically feasible (Recommended); 4) Leukocyte depletion filters (LDF) should be used when implementing IOCS in cancer patients (Strongly Recommended); 5) Irradiation treatment of autologous blood to be reinfused can be used when implementing IOCS in cancer patients (Recommended); 6) A careful assessment of the condition of cancer patients (meeting indications and excluding contraindications) should be conducted before implementing IOCS (Strongly Recommended); 7) Informed consent from cancer patients should be obtained when implementing IOCS, with a thorough pre-assessment of the patient's condition and the likelihood of blood loss, adherence to standardized internally audited management procedures, meeting corresponding conditions, and obtaining corresponding qualifications (Recommended). In brief, current evidence indicates that IOCS can be implemented for some malignant tumor patients who need allogeneic blood transfusion after physician full evaluation, and LDF or irradiation should be used during the implementation process.

Objective:To evaluate the efficacy and safety of the CLAE (cladribine + cytarabine + etoposide) regimen in refractory/relapsed T cell acute lymphoblastic leukemia/lymphoma (R/R T-ALL/LBL) .Methods:Patients with R/R T-ALL/LBL received the CLAE regimen in a prospective, multicenter, single-arm clinical study or compassionate use. From March 2019 to August 2024, data from 25 patients (18 in the study across five centers and 7 receiving compassionate treatment in Peking University Third Hospital) were collected. Outcomes included objective response rate, complete response (CR) rate, partial response (PR) rate after 1–2 cycles, bridging to allo-HSCT, progression-free survival (PFS), overall survival (OS), and treatment-related adverse effects.Results:Median age was 29 years (range, 13–63) ; 17 were male. Among the 24 evaluable patients, CR rate was 33.3% overall and 41.2% among enrolled patients. Median OS and PFS time were 199 (46–1 310) and 49 (28–1 310) days, respectively. Cumulative OS rate at 6 months, 1 year, and 2 years was (52.1±10.2) %, (29.7±9.3) %, and (27.1±9.1) %, respectively; cumulative PFS rate was (32.6±9.6) %, (24.9±8.9) %, and (23.8±8.7) %, respectively. Among patients achieving CR or PR (8 cases), median OS and PFS were not reached. Cumulative OS rate at 6 months, 1 year, and 2 years was (86.8±12.0) %, (78.3±14.6) %, and (72.9±15.7) %, respectively, and the cumulative PFS rate was (86.4±12.1) %, (74.8±15.3) %, and (72.9±15.7) %, respectively. Adverse events were mainly hematologic; no treatment-related mortality occurred. Seven patients achieving CR were bridged to allo-HSCT, with 5 remaining in continuous remission.Conclusion:The CLAE regimen is safe and effective for R/R T-ALL/LBL, facilitating CR as a bridge to allo-HSCT and potentially improving patient prognosis.

Objective:To construct a device-related pressure injury prevention program for orthopedic patients based on evidence-based and SSKINS (S: skin, S: surface, K: keep moving, I: incontinence, N: nutrition, S: self-care) clinical management model, and to provide reference for clinical nursing practice.Methods:In June 2023, a research team was set up to retrieve the literature related to device-related pressure injury in orthopedic patients, and the evidence was extracted and screened with reference to the SSKINS clinical management model, and the first draft of the protocol was formulated based on clinical practice. The final plan was determined through two rounds of expert consultations from October to December 2023.Results:The response rate of the two rounds of expert correspondence was 100%(20/20). The expert authority coefficients were 0.897 and 0.907, the overall Kendall coordination coefficients of the two rounds were 0.116 and 0.136 respectively, and the Kendall coordination coefficients of all levels were 0.104-0.213 (all P<0.001). The final protocol contains 6 first-level items (assessment and examination, the use and adjustment of device, prophylactic dressings, skin protection, nutritional support, health education) and 31 second-level items. Conclusions:The proposed orthopedic device-related pressure injury prevention program is scientific and practical, and can provide a reference for the prevention and management of clinical medical staff.